Grey scale and power Doppler sonographic changes induced by intra-articular steroid injection treatment.
OBJECTIVE
To investigate the ability of high resolution grey scale sonography (GSS) and power Doppler sonography (PDS) to assess short term soft tissue changes induced by intra-articular steroid injection in the small joints of patients with chronic synovitis.


METHODS
20 patients with clinically active synovitis of a small joint unresponsive to systemic drug treatment underwent a sonographic guided intralesional injection with triamcinolone acetonide. Clinical examinations were carried out by a trained rheumatologist. GSS and PDS examinations were performed independently by two examiners unaware of the results of the clinical examination. Joint cavity widening and power Doppler signal were evaluated and graded on a semiquantitative scale ranging from 1 to 4. Clinical and sonographic follow up examinations were carried out 2 weeks after the injection with triamcinolone acetonide.


RESULTS
All intra-articular injections were successfully carried out and documented under sonographic guidance. In 19/20 patients, baseline sonographic examinations clearly detected morphological and perfusional signs of synovitis. At follow up examinations, clinical and sonographic scores had improved significantly.


CONCLUSIONS
GSS and PDS appear to be a useful adjunctive tool for assessing short term soft tissue changes induced by intra-articular injection treatment with triamcinolone acetonide in small joints of patients with chronic arthritis.
Filippucci
E
E
Department of Rheumatology, Università Politecnica delle Marche, Italy.
Farina
A
A
Carotti
M
M
Salaffi
F
F
Grassi
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D013585:Synovitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods*
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide