The benefit of radiologically-guided steroid injections for trapeziometacarpal osteoarthritis.
BACKGROUND
Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. Conservative treatments include intra-articular steroid injections.


METHODS
This clinical, observational study prospectively reviewed the longevity of benefit of steroid injections into the TMJ. Eighty-three patients were recruited with a median age of 62 years and injected with steroid and local anaesthetic under radioscopic guidance. They were followed up until the analgesic effects ceased with a questionnaire including visual analogue scores.


RESULTS
Two-thirds of patients were improved at 2 months, with nearly half having a 3-month improvement. One in six patients had a 6-month benefit, with some patients still improved 2 years after injection. Previously injected patients had a reduced duration of benefit compared to their previous injection. Severity of osteoarthritis did not affect the injection efficacy.


CONCLUSIONS
Based on this study, we recommend steroid injections in all degrees of TMJ osteoarthritis.
Swindells
M G
MG
The Pulvertaft Hand Centre, Royal Derby Hospital, Derby DE22 3NE, UK. mgswindells@doctors.org.uk
Logan
A J
AJ
Armstrong
D J
DJ
Chan
P
P
Burke
F D
FD
Lindau
T R
TR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage; D052737:Carpometacarpal Joints / Q000000981:diagnostic imaging*; D004812:Epidemiologic Methods; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010147:Pain Measurement; D015641:Radiography, Interventional / Q000379:methods; D013933:Thumb; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use
D000779:Anesthetics, Local; D005938:Glucocorticoids; D014221:Triamcinolone