Can sonography be used to predict the response to intra‐articular corticosteroid injection in primary osteoarthritis of the knee?

Pendleton, Adrian; Millar, Auleen; O’Kane, Donal; Wright, Gary; Taggart, A J

doi:10.1080/03009740802050738

Cited by 34 publications

(43 citation statements)

References 8 publications

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“…One study has looked at the predictive value of musculoskeletal ultrasound in knee osteoarthritis,24 in which the presence of effusion, synovitis or power Doppler were not predictive of response to injection. However, the severity of disease was not equivalent to this study and knee osteoarthritis may well be a different disease, which may not respond in the same way to steroid injection.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis

Atchia

Kane

Reed

et al. 2010

Annals of the Rheumatic Diseases

144

155

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Section: Discussionmentioning

confidence: 99%

Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis

Atchia

Kane

Reed

et al. 2010

Annals of the Rheumatic Diseases

144

155

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“…No predictors of response were identified, perhaps a result of this study being underpowered. Pendleton et al (2008) examined similar clinical signs of inflammation; presence of heat, effusion and synovial thickening in addition to the presence of effusion and synovitis on knee US, as predictors of improvements in baseline WOMAC pain scale 1 and 6 weeks following CSI (67). The presence of heat was associated with 29% greater reduction in night pain, otherwise clinical and US inflammatory signs were not predictive of response.…”

Section: Inflammationmentioning

confidence: 99%

“…The evidence for synovitis on US as a predictor of response for outcomes following hip CSI is conflicting (22,64). There is little evidence to support the use of clinical inflammatory signs as predictors of response to CSI for knee OA (33,67) .Further research is required to determine whether signs of inflammation are useful predictors of response to conservative therapies for people with hip and knee OA.…”

Section: Inflammationmentioning

confidence: 99%

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Targeting Care

Eyles

Lucas

Hunter

2013

Rheumatic Disease Clinics of North America

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Important points and objectives for recall:• Numerous studies have explored patient characteristics including: body mass index, psychological factors, muscle strength, tibiofemoral alignment, radiographic changes and signs of inflammation as potential predictors of response to non-surgical interventions for management of hip and knee OA.• Often the sample sizes utilized by these studies were inadequate to yield sufficient numbers of responders to the interventions to allow for analysis of the potential predictors identified.• A number of well-designed studies were adequately powered to provide some evidence for clinical characteristics that did or did not predict response to non-surgical interventions for participants with hip and knee OA. SynopsisInternational evidence-based guidelines recommend a multitude of non-surgical treatment options for the management of OA. In the face of so many choices, it would be helpful for clinicians to be able to base treatment decisions on the identification of specific clinical presentations that foretell greater likelihood of success following a given treatment. This review summarizes the evidence available for patient characteristics that have been analysed as potential predictors of response to non-surgical interventions for patients with hip and knee OA. The specific variables targeted for this review include: body mass index, psychological factors, muscle strength, tibiofemoral alignment, radiographic changes and signs of inflammation. Several studies provide moderate to good evidence of potential predictors of response to non-surgical treatments, while areas for future research are illuminated.

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“…There are, however, significant variations in both the magnitude and duration of symptom relief following steroid injections [1, 4, 5, 8]. Such variation may be due to differences in the phenotypic expression, including severity of the disease; however, there are few published data on this issue and those studies that have examined structural factors predicting response have been small [6, 7, 9–14] and findings have been discrepant [6–8, 11, 13, 15]. Further, only radiographic [7, 9, 13, 15] and arthroscopic [7] predictor factors have been studied.…”

Section: Introductionmentioning

confidence: 99%

Structural predictors of response to intra-articular steroid injection in symptomatic knee osteoarthritis

et al. 2017

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BackgroundThe aim was to examine if structural factors could affect response to intra-articular steroid injections (IASI) in knee osteoarthritis (OA).MethodPersons with painful knee OA participated in an open-label trial of IASI where radiographic joint space narrowing (JSN) and Kellgren-Lawrence (KL) grade, whole-organ magnetic resonance imaging (MRI) scores (WORMS) and quantitative assessment of synovial tissue volume (STV) were assessed on baseline images. Participants completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and a question about knee pain with a visual analogue scale for pain during nominated activity (VASNA), and Outcome Measures in Rheumatology (OMERACT)-Osteoarthritis Research Society International (OARSI) criteria were used to assess responder status within 2 weeks (short term) and 6 months (longer term). Regression models were used to examine predictors of short and longer term response to IASI.ResultsSubjects (n = 207) attended and had IASI. Information on responder status was available on 199 participants. Of these, 188 subjects, mean age 63.2 years (standard deviation (SD) 10.3), 97 (51.6%) female, had x-rays and 120 had MRI scans available. Based on the OMERACT-OARSI criteria, 146 (73.4%) participants responded to therapy and 40 (20.1%) were longer term responders. A few factors were associated with a reduced KOOS-pain and VASNA response though none were associated with OMERACT-OARSI responder status in the short term. Higher MRI meniscal damage (odds ratio (OR) = 0.74; 95% CI 0.55 to 0.98), increasing KL maximal grade (OR = 0.43; 95% CI 0.23 to 0.82) and joint space narrowing (JSN) maximal score (OR = 0.60; 95% CI 0.36 to 0.99) were each associated with a lower odds of longer term responder status. Baseline synovitis was not associated with treatment response. The predicted probability of longer term response decreased from 38% to 12% as baseline maximal JSN increased from grade 0 to 3.ConclusionCompared with those who have mild structural damage, persons with more severe knee damage on either MRI or x-ray are less likely to respond to knee IASI.Trial registrationISRCTN.com, ISRCTN07329370. Registered 21 May 2010. Retrospectively registered

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Can sonography be used to predict the response to intra‐articular corticosteroid injection in primary osteoarthritis of the knee?

Cited by 34 publications

References 8 publications

Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis

Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis

Targeting Care

Structural predictors of response to intra-articular steroid injection in symptomatic knee osteoarthritis

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