Grey scale and power Doppler sonographic changes induced by intra-articular steroid injection treatment

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Ann Rheum Dis. 2004 Jun;63(6):740-3.

Grey scale and power Doppler sonographic changes induced by

intra-articular steroid injection treatment.

Filippucci E, Farina A, Carotti M, Salaffi F, Grassi W.

Department of Rheumatology, Universita Politecnica delle Marche, Italy.

OBJECTIVE: To investigate the ability of high resolution grey scale

sonography (GSS) and power Doppler sonography (PDS) to assess short term

soft tissue changes induced by intra-articular steroid injection in the

small joints of patients with chronic synovitis. METHODS: 20 patients

with clinically active synovitis of a small joint unresponsive to

systemic drug treatment underwent a sonographic guided intralesional

injection with triamcinolone acetonide. Clinical examinations were

carried out by a trained rheumatologist. GSS and PDS examinations were

performed independently by two examiners unaware of the results of the

clinical examination. Joint cavity widening and power Doppler signal

were evaluated and graded on a semiquantitative scale ranging from 1 to

4. Clinical and sonographic follow up examinations were carried out 2

weeks after the injection with triamcinolone acetonide. RESULTS: All

intra-articular injections were successfully carried out and documented

under sonographic guidance. In 19/20 patients, baseline sonographic

examinations clearly detected morphological and perfusional signs of

synovitis. At follow up examinations, clinical and sonographic scores

had improved significantly.

CONCLUSION: GSS and PDS appear to be a useful adjunctive tool for

assessing short term soft tissue changes induced by intra-articular

injection treatment with triamcinolone acetonide in small joints of

patients with chronic arthritis.

PMID: 15140784

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