Short-term efficacy to conventional blind injection versus ultrasound-guided injection of local corticosteroids in tenosynovitis in patients with inflammatory chronic arthritis: A randomized comparative study

Gutiérrez, Marwin; Matteo, Andrea Di; Rosemffet, Marcos; Cazenave, Tomás; Rodriguez-Gil, Gustavo; Díaz, Carlos Romero; Ríos, Lucio Ventura; Zamora, Natalia; Guzmán, María del Carmen González; Carrillo, Ignacio; Okano, Tadashi; Salaffi, Fausto; Pineda, Carlos

doi:10.1016/j.jbspin.2015.04.017

Cited by 38 publications

(27 citation statements)

References 38 publications

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“…In the present study, we have used US-guided injections to ensure correct placement of the BM in the tendon sheath,21 22 but we have not evaluated whether US-guided injections are better than blinded local injections. However, a recent study of TS has indicated better short-term effect of US-guided intratenosynovial injections compared with blinded injection of corticosteroid8 and therefore we find it recommendable to use US-guided intratenosynovial injections for local treatment of TS in patients with RA.…”

Section: Discussionmentioning

confidence: 95%

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Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis: a randomised, double-blind, controlled study

et al. 2016

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Section: Discussionmentioning

confidence: 95%

“…The current treatment strategy to rapidly reobtain disease control during flares is glucocorticoid treatment, either orally for a limited period or as injection or optimisation of DMARD treatment. Several studies have focused on controlling joint flares,3–6 while few studies have investigated treatment of TS flares in RA 7 8…”

Section: Introductionmentioning

confidence: 99%

Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis: a randomised, double-blind, controlled study

et al. 2016

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“…Utilizing US guidance for steroid injections into tendon sheaths has shown clinical advantage to conventional blind injections in the adult RA population [9], and this may be true in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

et al. 2017

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BackgroundThe aims of this study were to: (a) Identify tendon sheaths most commonly treated with steroid injections in a pediatric patient population with Juvenile Idiopathic Arthritis (JIA); (b) Describe technical aspects of the procedure; (c) Characterize sonographic appearance of tenosynovitis in JIA; (d) Assess agreement between clinical request and sites injected.MethodsThis was a 10 year single-center retrospective study (May 2006-April 2016) of patients with JIA referred by Rheumatology for ultrasound-guided tendon sheath injections. Patient demographics, clinical referral information, sonographic appearance of the tendon sheaths and technical aspects of the procedure were analyzed.ResultsThere were 308 procedures of 244 patients (75% female, mean age 9.6 years) who underwent a total of 926 tendon sheath injections. Ankle tendons were most commonly injected (84.9%), specifically the tendon sheaths of tibialis posterior (22.3%), peroneus longus (20%) and brevis (19.7%). The majority of treated sites (91.9%) showed peritendinous fluid and sheath thickening on ultrasound. There were 2 minor intra-procedure complications without sequelae. A good agreement between clinical request and sites injected was observed.ConclusionsUltrasound-guided tendon sheath injections with steroids are used frequently to treat patients with JIA. It is a safe intervention with a high technical success rate. The ankle region, specifically the medial compartment, is the site most commonly injected in this group of patients. The most common sonographic finding is peritendinous fluid and sheath thickening. These findings might assist clinicians and radiologists to characterize and more effectively manage tenosynovitis in patients with JIA.

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“…Inflammatory tenosynovitis (and bursitis) associated with rheumatic diseases such as rheumatoid arthritis, psoriasis, and other spondyloarthropathies, similarly to articular synovitis, responds favorably to corticosteroid injections. 70 In our experience, intrasheath ultrasound-guided injections of even very small doses of corticosteroids (8 mg methylprednisolone) is very efficient at treating proliferative tenosynovitis in the hands, ankles, and feet. To minimize the potential adverse effects of corticosteroids on the tendon, care should be taken to avoid an intratendinous injection, and a more soluble corticosteroid preparation is recommended as well as relative rest of the affected area for 2 weeks following the injection, but these recommendations are anecdotal and not based on scientific evidence.…”

Section: Tendon Disordersmentioning

confidence: 88%

Injectable Corticosteroids: Take Precautions and Use Caution

Freire

Bureau

2016

Semin Musculoskelet Radiol

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Corticosteroids are routinely injected into soft tissues, tendon sheaths, bursae, and joints. These anti-inflammatory agents have different potency and solubility, and solubility is inversely correlated with the duration of action. Corticosteroids carry a low risk of complications but commonly cause systemic and local adverse effects. The use of intra-articular corticosteroid injections in the treatment of inflammatory arthritis and osteoarthritis is well established. Evidence also supports the use of injectable corticosteroids in the treatment of inflammatory tenosynovitis and bursitis associated with rheumatic diseases, trigger finger and de Quervain disease, and carpal tunnel syndrome. The role of corticosteroid injections in the management of rotator cuff disease remains unclear. Strong scientific evidence indicates that corticosteroid injections for lateral epicondylosis worsen the long-term outcomes of patients. This review article discusses the considerations related to the use of corticosteroid injections in the management of nonspinal musculoskeletal conditions.

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Short-term efficacy to conventional blind injection versus ultrasound-guided injection of local corticosteroids in tenosynovitis in patients with inflammatory chronic arthritis: A randomized comparative study

Cited by 38 publications

References 38 publications

Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis: a randomised, double-blind, controlled study

Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis: a randomised, double-blind, controlled study

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study

Injectable Corticosteroids: Take Precautions and Use Caution

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