Corticosteroid injections reduce size of rheumatoid nodules.
BACKGROUND
Symptomatic rheumatoid nodules are frequently surgically treated. Injection with steroids might be an alternative treatment.


METHODS
To determine whether injection with triamcinolon acetonide reduces the size of rheumatoid nodules, we randomized twenty patients with symptomatic nodules to either triamcinolon acetonide 40 mg/ml plus lidocaine 2% or lidocaine 1% (placebo). We measured the nodules before injection and 2, 4, 8, and 12 weeks after injection. Possible side effects were recorded.


RESULTS
We found that the volume of the nodules injected with triamcinolon acetonide reduced significantly (p = 0.011), from 130 to 8 mm(3) (median calculated size) at 12 weeks, compared with baseline. Furthermore, at 12 weeks, the difference between the groups was significant (p = 0.03). The median size of the placebo nodules diminished as well, from 358 to 237 mm(3), but this was not significant. Pain at injection was the only side effect, equally distributed in both treatment groups.


CONCLUSIONS
Injection with triamcinolon acetonide seems to be an alternative for surgery of rheumatoid nodules. No adverse events occurred but the limited sample does not allow definitive conclusions.
Baan
H
H
Department of Rheumatology, Medisch Spectrum Twente, Enschede, P.O.Box 50.000, 7500KA, The Netherlands. h.baan@ziekenhuis-mst.nl
Haagsma
C J
CJ
van de Laar
M A F J
MA
D000779:Anesthetics, Local; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006304:Health Status; D006801:Humans; D007267:Injections; D015552:Injections, Intralesional; D008012:Lidocaine / Q000008:administration & dosage; D012218:Rheumatoid Nodule / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*
D000779:Anesthetics, Local; D005938:Glucocorticoids; D008012:Lidocaine; D014222:Triamcinolone Acetonide