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Intra articular steroid injection

Alexandre Dumusc, Thomas Hügle
Reactive arthritis is usually regarded as a form of spondylarthritis. Patients generally present with an acute asymmetrical oligoarthritis following an episode of diarrhea or urethritis. The most frequent involved pathogens are Salmonella, Shigella, Campylobacter and Chlamydia trachomatis. Additional causative pathogens have been described. Non-steroidal anti-inflammatory drugs are the first line treatment for reactive arthritis, associated with physiotherapy. Occasionally, a short course of glucocorticoids or an intra-articular injection is needed...
March 7, 2018: Revue Médicale Suisse
Flemming K Nielsen, Mikael Boesen, Anne Grethe Jurik, Henning Bliddal, Janus Damm Nybing, Karen Ellegaard, Cecilie Bartholdy, Elisabeth Bandak, Marius Henriksen
OBJECTIVE: To evaluate if the relative volume of bone marrow lesions (BMLs) changed in patients with knee osteoarthritis (OA) during a therapeutic study. DESIGN: This study is a sub-study to a larger clinical trial which compared the clinical effects of intra-articular corticosteroid injection in knee OA to placebo injection, both given prior to exercise therapy. Clinical assessment using the Knee injury Osteoarthritis Outcome Score (KOOS) and MRI examinations with BML assessments were performed at baseline and follow-up after 14 weeks and 26 weeks, respectively...
February 27, 2018: Osteoarthritis and Cartilage
Rozalin R Dickson, Joel M Reid, Wayne T Nicholson, Tim J Lamer, W Michael Hooten
BACKGROUND: Facet joint steroid injections are used to treat chronic low back. However, little is known about the systemic absorption and serum levels of steroids following intra-articular facet joint injections. The primary objective of this preliminary study was to investigate the pharmacokinetics of triamcinolone acetonide following fluoroscopically guided intra-articular lumbar facet joint injections in a cohort of patients with chronic low back pain. A secondary aim was to investigate the effects of triamcinolone on serum cortisol levels following lumbar facet joint injections...
February 12, 2018: Pain Practice: the Official Journal of World Institute of Pain
Sascha Hopp, Ishaq Ojodu, Atul Jain, Tobias Fritz, Tim Pohlemann, Jens Kelm
INTRODUCTION: Radiographic abnormalities of the symphysis as well as the formation of accessory clefts, indicating injury at the rectus-adductor aponeurosis, reportedly relate to longstanding groin pain in athletes. However, yet, no systematic classification for clinical and scientific purposes exists. We aimed to (1) create a radiographic classification based on symphysography; (2) test intra- and interobserver reliability; (3) characterise clinical significance of the morphologic patterns by evaluating success of injection therapy...
February 7, 2018: Archives of Orthopaedic and Trauma Surgery
Gregory S Antonarakis, Delphine S Courvoisier, Sylviane Hanquinet, Amira Dhouib, Raffaella Carlomagno, Michaël Hofer, Paolo Scolozzi
PURPOSE: The aim of the present investigation was to evaluate, in patients with juvenile idiopathic arthritis, the effect of lavage with or without intra-articular corticosteroid (IACS) injection on clinical temporomandibular joint (TMJ) signs and symptoms of inflammation and changes in acute inflammation as assessed using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Forty-one patients (mean age, 13.6 ± 4.0 yr) with juvenile idiopathic arthritis participating in a large prospective juvenile inflammatory rheumatism cohort study (JIRcohorte) were included in this study...
January 8, 2018: Journal of Oral and Maxillofacial Surgery
Margaret Coutts, Rowena Soriano, Rajendran Naidoo, Habib Torfi
Clinical and laboratory results document psoriatic arthritis in a 56-year old patient. The symptoms did not resolve with standard treatments (nonsteroidal anti-inflammatory drugs, steroids and methotrexate). TNF-alpha inhibitors (certolizumab pegol and adalimumab) were added to the treatment regime, with some adverse effects. A trial of human umbilical cord stem cell therapy was then initiated. The stem cells were enriched and concentrated from whole cord blood, by removal of erythrocytes and centrifugation...
December 26, 2017: World Journal of Stem Cells
Stephen Brealey, Alison L Armstrong, Andrew Brooksbank, Andrew Jonathan Carr, Charalambos P Charalambous, Cushla Cooper, Belen Corbacho, Joseph Dias, Iona Donnelly, Lorna Goodchild, Catherine Hewitt, Ada Keding, Lucksy Kottam, Sarah E Lamb, Catriona McDaid, Matthew Northgraves, Gerry Richardson, Sara Rodgers, Sarwat Shah, Emma Sharp, Sally Spencer, David Torgerson, Francine Toye, Amar Rangan
BACKGROUND: Frozen shoulder (also known as adhesive capsulitis) occurs when the capsule, or the soft tissue envelope around the ball and socket shoulder joint, becomes scarred and contracted, making the shoulder tight, painful and stiff. It affects around 1 in 12 men and 1 in 10 women of working age. Although this condition can settle with time (typically taking 1 to 3 years), for some people it causes severe symptoms and needs referral to hospital. Our aim is to evaluate the clinical and cost-effectiveness of two invasive and costly surgical interventions that are commonly used in secondary care in the National Health Service (NHS) compared with a non-surgical comparator of Early Structured Physiotherapy...
December 22, 2017: Trials
Saowarat Snidvongs, Rod S Taylor, Alia Ahmad, Simon Thomson, Manohar Sharma, Angela Farr, Deborah Fitzsimmons, Stephanie Poulton, Vivek Mehta, Richard Langford
BACKGROUND: Pain of lumbar facet-joint origin is a common cause of low back pain in adults and may lead to chronic pain and disability, with associated health and socioeconomic implications. The socioeconomic burden includes an inability to return to work resulting in loss of productivity in addition to direct and indirect health-care utilisation costs. Lumbar facet-joints are paired synovial joints between the superior and inferior articular processes of consecutive lumbar vertebrae and between the fifth lumbar vertebra and the sacrum...
December 2017: Health Technology Assessment: HTA
P Gisondi, G Altomare, F Ayala, A Conti, P Dapavo, C De Simone, C Foti, L Idolazzi, E Lubrano, G Malara, A Marchesoni, I Olivieri, A Parodi, K Peris, S Piaserico, C Salvarani, R Scarpa, G Girolomoni
BACKGROUND: Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (PsO). Early diagnosis and prompt therapeutic intervention are crucial for limiting PsA progression and prevention of disability. Dermatologists are in a privileged position to detect early PsA. The management of patients with PsA in the dermatology setting is widely variable. OBJECTIVE: To provide practical recommendations for the management of patients with PsA in the dermatology setting including early diagnosis and treatment...
December 8, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
Abhishek Abhishek
Gout is common in the elderly, affecting an estimated 4.7 million people aged > 60 years in the USA alone. The incidence and prevalence of gout increases, and male predisposition to gout reduces, with increasing age. The elderly have more comorbidities, and gout manifests differently, with more frequent involvement of knees, ankles, and wrists at disease onset, systemic upset, and tophi. Comorbidities and polypharmacy make the management of gout flares challenging in this population. Intra-articular corticosteroid injection remains the treatment of choice for accessible joints, oral prednisolone is preferred over low-dose colchicine, and non-steroidal anti-inflammatory drugs (NSAIDs) are best avoided...
December 2017: Drugs & Aging
Donghwi Park, Kwang Jae Yu, Ju Young Cho, Seung Beom Woo, Junu Park, Zeeihn Lee, Jong Min Kim
The aim of this study was to investigate the effects of intra-articular injection of polydeoxyribonucleotide (PDRN), compared with intraarticular triamcinolone (TA) injection, in subacute stroke patients with hemiplegic shoulder pain (HSP).Participants were subacute stroke patients with HSP who had undergone 2 consecutive intra-articular injections of TA or PDRN.Numeric rating scale (NRS) and passive range of motion (PROM) of hemiplegic shoulder were evaluated until 4 weeks after 2nd injection.In the results, there were significant improvements in all PROM measures 2 weeks after the second injection, compared with pre-injection results, in both groups (P < ...
November 2017: Medicine (Baltimore)
Sara Tenti, Nicola Antonio Pascarelli, Stefano Giannotti, Mauro Galeazzi, Nicola Giordano, Antonella Fioravanti
BACKGROUND: Osteoarthritis (OA) of the trapeziometacarpal joint (TMJ) is a disabling condition with a significant impact on quality of life. The optimal management of hand OA requires a combination of non-pharmacological and pharmacological treatments that include intra-articular (i.a.) therapy. EULAR experts recommend corticosteroid injections in TMJ OA and underline the usefulness of hyaluronic acid (HA). The aim of this study was the assessment of the efficacy and tolerability of i...
November 13, 2017: BMC Musculoskeletal Disorders
Tim Davis, Eric Loudermilk, Michael DePalma, Corey Hunter, David Lindley, Nilesh Patel, Daniel Choi, Marc Soloman, Anita Gupta, Mehul Desai, Asokumar Buvanendran, Leonardo Kapural
BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) of the knee affects the aging population and has an associated influence on the health care system. Rigorous studies evaluating radiofrequency ablation for OA-related knee pain are lacking. This study compared long-term clinical safety and effectiveness of cooled radiofrequency ablation (CRFA) with intra-articular steroid (IAS) injection in managing OA-related knee pain. METHODS: This is a prospective, multicenter, randomized trial with 151 subjects with chronic (≥6 months) knee pain that was unresponsive to conservative modalities...
November 1, 2017: Regional Anesthesia and Pain Medicine
Krzysztof Orczyk, Elzbieta Smolewska
Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in childhood. Up to 50% of patients are resistant to standard therapy, which includes non-steroid anti-inflammatory drugs, corticosteroids, disease-modifying anti-rheumatic drugs and biologic therapies. Intra-articular injection of mesenchymal stem cells (MSCs) is proposed as a new approach to JIA treatment. MSCs can modulate inflammation via mechanisms of both adaptive and innate immune response. They are able to inhibit T and B cell proliferation, promote regulatory T cells, suppress the maturation of dendritic cells, stimulate macrophage differentiation into M2 phenotype and reduce effectiveness of natural killer cells...
October 13, 2017: Archivum Immunologiae et Therapiae Experimentalis
Christopher R Byron, Richard A Trahan
Osteoarthritis (OA) is a ubiquitous disease affecting many horses. The disease causes chronic pain and decreased performance for patients and great cost to owners for diagnosis and treatment. The most common treatments include systemic non-steroidal anti-inflammatory drugs and intra-articular injection of corticosteroids. There is excellent support for the palliative pain relief these treatments provide; however, they do not arrest progression and may in some instances hasten advancement of disease. Orthobiologic treatments have been investigated as potential OA treatments that may not only ameliorate pain but also prevent or reverse pathologic articular tissue changes...
2017: Frontiers in Veterinary Science
Timothy E McAlindon, Michael P LaValley
No abstract text is available yet for this article.
September 26, 2017: JAMA: the Journal of the American Medical Association
William J Maloney, David S Jevsevar, Kevin G Shea
No abstract text is available yet for this article.
September 26, 2017: JAMA: the Journal of the American Medical Association
Pim A J Luijsterburg, Pieter K Bos, Sita M A Bierma-Zeinstra
No abstract text is available yet for this article.
September 26, 2017: JAMA: the Journal of the American Medical Association
Christelle Nguyen, Isabelle Boutron, Gabriel Baron, Emmanuel Coudeyre, Francis Berenbaum, Serge Poiraudeau, François Rannou
INTRODUCTION: Osteoarthritis (OA) pathophysiology is driven in part by joint inflammation. Resveratrol has in vitro anti-inflammatory properties. We aim to assess the efficacy of oral resveratrol for knee pain at 3 months in people with knee OA. METHODS AND ANALYSIS: We will conduct a randomised double-blind placebo-controlled trial. Overall, 164 individuals with knee OA fulfilling 1986 American College of Rheumatology criteria will be recruited in three tertiary care centres in France and randomised to receive oral resveratrol, 40 mg (two caplets) two times per day for 1 week, then 20 mg (one caplet) two times per day or a matching placebo for a total of 6 months...
September 29, 2017: BMJ Open
Mohmad Attia Mortada, Shimaa Mustafa Abdelwhab, Mohmad H Elgawish
The effects of intra-articular methotrexate (I/A MTX) in knee synovitis in rheumatoid arthritis have been previously evaluated. I/A MTX has not been studied in other joints. Ultrasonography (US) has been little studied in monitoring the effect of I/A MTX. The aim of the study is to test the efficacy of I/A MTX in suppression of persistent synovitis in medium-sized joints (ankle, wrist, and elbow) in rheumatoid arthritis patients. Patients were divided into two groups: group 1 (methotrexate group): 56 patients in which 84 joints (32 ankles, 28 wrists, and 24 elbows) were injected intra-articularly by 10 mg of methotrexate in the targeted joint on a weekly basis for 8 weeks and group 2 (steroid group): 44 patients in which 70 joints (26 ankles, 24 wrists, and 20 elbows) were injected once by Triamcinolone acetonide 40 mg...
September 30, 2017: Clinical Rheumatology
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