title: CS injection of tenosynovitis in patients with chronic inflammatory arthritis: the role of US.
abstract: OBJECTIVE
  The main aim of this study was to investigate the short-term efficacy of CS loco-regional treatment performed under US guidance in tenosynovitis of patients with chronic inflammatory arthritis.
  
  
  METHODS
  Thirty consecutive patients affected by chronic arthritis and with clinical suspicion of tenosynovitis were recruited to undergo US assessment. In the sonographically proven cases, US-guided CS injection was performed. A visual analogue scale for pain (ranging from 0 to 10) and a tenderness score (ranging from 0 to 3) were used for the clinical evaluation. Sonographic pathological findings indicative of tenosynovitis were scored using a semi-quantitative 4-grade scoring system, for both grey-scale and power Doppler US, at baseline and during a follow-up visit at 2 weeks after the CS injection.
  
  
  RESULTS
  In 21 (70%) of 30 patients, the clinical suspicion of tenosynovitis was confirmed (9 with RA, 11 with PsA and 1 with ReA). In the other nine patients, US revealed synovitis of the adjacent joints, bursitis, oedema of the s.c. tissue or a partial tear. In all cases the appropriate needle placement and subsequent CS injection into the tendon sheath were obtained with US confirmation. A significant reduction in all clinical and sonographic scorings was found during the follow-up visit.
  
  
  CONCLUSIONS
  The present study shows the efficacy of US-guided peritendinous CS injections in the management of patients with chronic inflammatory arthritis presenting as US-proven tenosynovitis.
authors.affiliation: Clinica Reumatologica, Università Politecnica delle Marche, Ospedale 'C. Urbani', 52, Via dei Colli, 60035 - Jesi, Ancona, Italy. lucadigeso@libero.it
authors.forename: Luca
authors.initials: L
authors.lastname: Di Geso
authors.forename: Emilio
authors.initials: E
authors.lastname: Filippucci
authors.forename: Gary
authors.initials: G
authors.lastname: Meenagh
authors.forename: Marwin
authors.initials: M
authors.lastname: Gutierrez
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ciapetti
authors.forename: Fausto
authors.initials: F
authors.lastname: Salaffi
authors.forename: Walter
authors.initials: W
authors.lastname: Grassi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002908:Chronic Disease; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D000091402:Prohibitins; D013717:Tenosynovitis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; C000717331:PHB2 protein, human; D000091402:Prohibitins