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Ann Rheum Dis 2000;59:233-235 ( March )

Concise report

Importance of synovial fluid aspiration when injecting intra-articular corticosteroids Tomas Weitoft, Per Uddenfeldt

Section of Rheumatology, Department of Internal Medicine, County Hospital Gävle-Sandviken, S-801 87 Gävle, Sweden

Correspondence to: Dr Weitoft

Accepted for publication 1 December 1999

OBJECTIVE---The aim of this prospective study was to find if a complete synovial fluid aspiration before injecting intra-articular corticosteroids influences the treatment result.
METHODS---The study was performed in 147 patients with rheumatoid arthritis (RA). One hundred and ninety one knees with synovitis were randomised to arthrocentesis (n=95) or no arthrocentesis (n=96) before 20 mg triamcinolone hexacetonide was injected. The duration of effect was followed up for a period of six months. All patients were instructed to contact the rheumatology department if signs and symptoms from the treated knee recurred. If arthritis could be confirmed by a clinical examination a relapse was noted.
RESULTS---There was a significant reduction of relapse in the arthrocentesis group (p=0.001).
CONCLUSION---The study shows that aspiration of synovial fluid can reduce the risk for arthritis relapse when treating RA patients with intra-articular corticosteroids. It is concluded that arthrocentesis shall be included in the intra-articular corticosteroid injection procedure.

© 2000 by Annals of the Rheumatic Diseases


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