title: Accuracy of intra-articular injections in peripheral joints performed blindly in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To assess the accuracy of blind IA injections (IAIs) in patients with RA and determine their effectiveness.
  
  
  METHODS
  A controlled prospective study including 96 RA patients undergoing blind IAIs in peripheral joints was carried out. Clinical evaluation was performed at baseline (T(0)), 1 (T(1)) and 4 (T(4)) weeks after IAI using the following instruments: visual analogue scale (VAS) for pain at rest and movement, VAS for oedema (range 0-10 cm) and morning stiffness. Following IAI, radiographic exam was performed in all joints for further analysis by two 'blinded' radiologists. The kappa-statistic, chi-square and analysis of variance tests were performed to determine potential differences between time-points of evaluation. Significance level was set as P < 0.05.
  
  
  RESULTS
  A total of 232 injections were performed. Accuracy observed for the shoulder, elbow, wrist, MCP joints, knee and ankle were 82, 100, 97, 97, 100 and 77%, respectively. A statistically significant improvement was observed for all variables at both T(1) and T(4) when compared with T(0).
  
  
  CONCLUSIONS
  Blind IAI proved safe and accurate when performed by a trained professional. Significant improvement was seen in the VAS for pain at rest and during movement, VAS for oedema and morning stiffness.
authors.affiliation: Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu, 740, 04023-900 - São Paulo, Brazil.
authors.forename: R V
authors.initials: RV
authors.lastname: Lopes
authors.forename: R N V
authors.initials: RN
authors.lastname: Furtado
authors.forename: L
authors.initials: L
authors.lastname: Parmigiani
authors.forename: A
authors.initials: A
authors.lastname: Rosenfeld
authors.forename: A R C
authors.initials: AR
authors.lastname: Fernandes
authors.forename: J
authors.initials: J
authors.lastname: Natour
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002983:Clinical Competence; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide