The action of hydrocortisone in synovial inflammation.

The anti-inflammatory effects of systemic cortisone (compound E) have been amply demonstrated in the treatment of rheumatoid arthritis (1, 2) and in experimental models in animals (3, 4). Similarly, the local use of cortisone in the treatment of inflammatory conditions of the eye (5, 6) and the effectiveness of this hormone in blocking the host reaction to a turpentine abscess (4) have given eloquent testimony to its local effect. Compound F (hydrocortisone) acetate has been demonstrated by Hollander, Brown, Jessar, and Brown (7) to lower joint temperatures and to exert a clinically beneficial effect when injected into the joints of patients with either rheumatoid or degenerative arthritis. This phenomenon was not noted with the use of cortisone. These clinical findings have been confirmed repeatedly (8, 9, 10) and additional experimental data have accumulated (11) to suggest the efficacy of hydrocortisone acetate as a potent anti-inflammatory agent for local use. In an attempt to obtain a further clue to the explanation of the clinical response observed with intra-articular compound F acetate, we have studied changes in joint fluid following treatment with this agent.