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.
McCarthy
C J
CJ
Department of Rheumatology, Mater Hospital, Dublin, Ireland.
Regan
M
M
Coughlan
R J
RJ
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