Radiographic patterns and response to corticosteroid hip injection.
نویسندگان
چکیده
OBJECTIVES A prospective, open study of corticosteroid hip injection (CHI) was performed to determine if different radiological patterns of arthritis vary in their response. METHODS Forty five patients (15 with rheumatoid arthritis, 27 with osteoarthritis, and three with anklyosing spondylitis) underwent hip injection with 80 mg methylprednisolone and lignocaine under x ray control. Outcome was assessed at two, 12, and 26 weeks for pain, range of hip movement, and graded functional questionnaire. Patients estimated their pain in four components, night pain, rest pain, weight bearing, and referred pain, each measured by 10 cm visual analogue score and summed to give a total score out of 40 cm. Hip radiographs were evaluated blindly for pattern and severity of arthritis, as well as for progression between 0 and 26 weeks. RESULTS Median total pain score decreased from 29 cm at baseline to 22 cm at two weeks (p = 0.0001), 24 cm at 12 weeks (p = 0.03), but had returned nearly to baseline by 26 weeks (25 cm, p = 0.3). Greatest improvement was seen for night pain. Mean range of internal rotation increased from 16 to 28 degrees at two weeks (p = 0.03) and 21 degrees at 12 weeks (p = 0.06). Functional ability did not change. Hips with an atrophic pattern of arthritis on plain radiography gained negligible pain relief at two weeks compared with hips with a hypertrophic or mixed bone response (p = 0.04). The degree of pain relief was similar in patients with OA and RA, and was not influenced by radiographic severity or by the direction of migration of the femoral head. CONCLUSION Pain and internal rotation improve for up to 12 weeks after CHI. CHI offers a useful and safe therapeutic option for patients with hip arthritis, with the exception of those with a purely atrophic radiological pattern.
منابع مشابه
Melkersson-Rosenthal syndrome: Appropriate response to the combination treatment with intralesional triamcinolone injection and oral azithromycin
Melkersson-Rosenthal syndrome is an uncommon disorder which is presented by a triad of lip swelling, facial nerve palsy, and a fissured tongue. A number of treatments have been reported for this syndrome with variable outcomes. We have reported a 38-year-old female patient with lower lip swelling and a fissured tongue on clinical examination. She was also suffering from facial nerve paralysis s...
متن کاملIntraarticular cortisone injection for osteoarthritis of the hip. Is it effective? Is it safe?
Osteoarthritis of the hip is a significant source of morbidity in the elderly. Treatment guidelines are available for the management of hip osteoarthritis, but these do not address the application of intraarticular corticosteroid injection. The intraarticular injection of corticosteroid is used in the management of other large joint osteoarthritic diseases and is well studied in the knee, howev...
متن کاملBlood Glucose Levels in Diabetic Patients Following Corticosteroid Injections into the Subacromial Space of the Shoulder
Background: Corticosteroid injections are used to treat a variety of orthopedic conditions with the goal of decreasingpain and inflammation. Administration of systemic or local corticosteroids risks temporarily increasing blood glucoselevels, especially diabetic patients. The purpose of this study is to quantify the effects of corticosteroid injections onblood glucose levels in diabetic patient...
متن کاملEffectiveness of intramuscular corticosteroid injection versus placebo injection in patients with hip osteoarthritis: design of a randomized double-blinded controlled trial
BACKGROUND Recent international guidelines recommend intra-articular corticosteroid injections for patients with hip osteoarthritis who have moderate to severe pain and do not respond satisfactorily to oral analgesic/anti-inflammatory agents. Of the five available randomized controlled trials, four showed positive effects with respect to pain reduction. However, intra-articular injection in the...
متن کاملUltrasound-guided Intraarticular Hip Injection for Osteoarthritis Pain in the Emergency Department
Ultrasound-guided intraarticular hip corticosteroid injections may be useful for emergency care providers treating patients with painful exacerbations of osteoarthritis of the hip. Corticosteroid injection is widely recommended as a first-line treatment for painful osteoarthritis of the hip. Bedside ultrasound is readily available in most emergency departments; however, using ultrasound to guid...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Annals of the rheumatic diseases
دوره 56 8 شماره
صفحات -
تاریخ انتشار 1997