Importance of synovial fluid aspiration when injecting intra-articular corticosteroids.
OBJECTIVE
The aim of this prospective study was to find if a complete synovial fluid aspiration before injecting intra-articular corticosteroids influences the treatment result.


METHODS
The study was performed in 147 patients with rheumatoid arthritis (RA). One hundred and ninety one knees with synovitis were randomised to arthrocentesis (n=95) or no arthrocentesis (n = 96) before 20 mg triamcinolone hexacetonide was injected. The duration of effect was followed up for a period of six months. All patients were instructed to contact the rheumatology department if signs and symptoms from the treated knee recurred. If arthritis could be confirmed by a clinical examination a relapse was noted.


RESULTS
There was a significant reduction of relapse in the arthrocentesis group (p = 0.001).


CONCLUSIONS
The study shows that aspiration of synovial fluid can reduce the risk for arthritis relapse when treating RA patients with intra-articular corticosteroids. It is concluded that arthrocentesis shall be included in the intra-articular corticosteroid injection procedure.
Weitoft
T
T
Section of Rheumatology, Department of Internal Medicine, County Hospital Gävle-Sandviken, S-801 87 Gävle, Sweden.
Uddenfeldt
P
P
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013396:Suction; D013582:Synovial Fluid; D013585:Synovitis / Q000188:drug therapy; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide