Accuracy of intra-articular injections in peripheral joints performed blindly in patients with rheumatoid arthritis.
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.
Lopes
R V
RV
Disciplina de Reumatologia, Universidade Federal de São Paulo, Rua Botucatu, 740, 04023-900 - São Paulo, Brazil.
Furtado
R N V
RN
Parmigiani
L
L
Rosenfeld
A
A
Fernandes
A R C
AR
Natour
J
J
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
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide