Treatment of rheumatoid hand synovitis with a regional block technique.
This study reports a novel technique for treating painful rheumatoid hand synovitis using a regional block technique. Nine patients with symptomatic rheumatoid hand synovitis were treated. Assessments of symptoms, grip strength and synovial swelling were made in each hand before the injection, and at 1 and 4 weeks after the procedure. A sphygmomanometer cuff was inflated, on the side of the patients most symptomatic hand, to 220mmHg and a solution of hydrocortisone sodium succinate 50mgs and lignocaine 10mls 0.5% was injected intravenously. The cuff was deflated slowly after 20 minutes. The injected hand improved symptomatically in 7 patients at 1 week, and further improvement was reported in 6 of these 7 at 1 month. Mean grip strength increased significantly in the injected hand both at 1 week (p = 0.01) and 1 month (p = 0.018). There was no change in the other hand. This technique is safe, reduced hand pain and improved grip strength in these patients with rheumatoid hand synovitis.
Department of Rheumatology, Mater Hospital, Dublin, Ireland.
C J
CJ
McCarthy
M
M
Regan
R J
RJ
Coughlan
D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D006225:Hand; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D013585:Synovitis / Q000188:drug therapy* / Q000209:etiology; D014111:Tourniquets
D008012:Lidocaine; C007133:hydrocortisone hemisuccinate; D006854:Hydrocortisone