Clinica Reumatologica, Università Politecnica delle Marche, Ospedale 'C. Urbani', 52, Via dei Colli, 60035 - Jesi, Ancona, Italy.
Rheumatology (Oxford). 2012 Jul;51(7):1299-303. doi: 10.1093/rheumatology/kes027. Epub 2012 Mar 5.
The main aim of this study was to investigate the short-term efficacy of CS loco-regional treatment performed under US guidance in tenosynovitis of patients with chronic inflammatory arthritis.
Thirty consecutive patients affected by chronic arthritis and with clinical suspicion of tenosynovitis were recruited to undergo US assessment. In the sonographically proven cases, US-guided CS injection was performed. A visual analogue scale for pain (ranging from 0 to 10) and a tenderness score (ranging from 0 to 3) were used for the clinical evaluation. Sonographic pathological findings indicative of tenosynovitis were scored using a semi-quantitative 4-grade scoring system, for both grey-scale and power Doppler US, at baseline and during a follow-up visit at 2 weeks after the CS injection.
In 21 (70%) of 30 patients, the clinical suspicion of tenosynovitis was confirmed (9 with RA, 11 with PsA and 1 with ReA). In the other nine patients, US revealed synovitis of the adjacent joints, bursitis, oedema of the s.c. tissue or a partial tear. In all cases the appropriate needle placement and subsequent CS injection into the tendon sheath were obtained with US confirmation. A significant reduction in all clinical and sonographic scorings was found during the follow-up visit.
The present study shows the efficacy of US-guided peritendinous CS injections in the management of patients with chronic inflammatory arthritis presenting as US-proven tenosynovitis.
本研究的主要目的是探讨在超声引导下进行局部皮质类固醇（CS）治疗在慢性炎症性关节炎患者腱鞘炎中的短期疗效。
连续招募了 30 名患有慢性关节炎且临床怀疑患有腱鞘炎的患者进行超声评估。在超声证实的病例中，进行了超声引导下 CS 注射。采用视觉模拟评分法（范围 0-10）和压痛评分（范围 0-3）进行临床评估。使用半定量 4 级评分系统，对灰阶和能量多普勒超声的腱鞘炎的超声病理表现进行评分，分别在基线时和 CS 注射后 2 周的随访时进行。
在 30 名患者中的 21 名（70%），临床怀疑的腱鞘炎得到了证实（9 名类风湿关节炎、11 名银屑病关节炎和 1 名反应性关节炎）。在其他 9 名患者中，超声显示相邻关节滑膜炎、滑囊炎、皮下组织水肿或部分撕裂。在所有病例中，均通过超声确认了适当的针位和随后的 CS 注射到腱鞘中。在随访时，所有临床和超声评分均显著降低。
本研究表明，在患有慢性炎症性关节炎的患者中，超声引导下的腱鞘周围 CS 注射在治疗超声证实的腱鞘炎方面是有效的。
