Importance of immobilization after intraarticular glucocorticoid treatment for elbow synovitis: a randomized controlled study.
OBJECTIVE
To investigate whether better treatment results might be achieved with postinjection rest following intraarticular glucocorticoid treatment for elbow synovitis.


METHODS
Ninety patients with rheumatoid arthritis and elbow synovitis were treated with 20 mg of intraarticular triamcinolone hexacetonide and randomized to either a 48-hour immobilization in a triangular sling (n = 46) or to normal activity without restrictions (n = 44). The primary end point was relapse of synovitis. In addition, pain, function according to a self-assessment questionnaire (the Patient Rated Elbow Evaluation), and range of movement were followed for 6 months.


RESULTS
Thirteen relapses occurred in the rest group and 8 in the active group (results not significant). The secondary measures showed no statistically significant differences between the groups.


CONCLUSIONS
Immobilization procedures do not improve the outcome of intraarticular glucocorticoid therapy for elbow synovitis. In future guidelines for such treatment of the upper extremity, normal activity after the injection should be recommended.
Weitoft
Tomas
T
Center for Research and Development, County Council of Gävleborg/Uppsala University, Uppsala, and Gävle Hospital, Gävle, Sweden. tomas.weitoft@lg.se.
Forsberg
Catarina
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D004551:Elbow Joint; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007103:Immobilization; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013585:Synovitis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids