TREATMENT OF RHEUMATOID JOINT INFLAMMATION WITH INTRASYNOVIAL TRIAMCINOLONE HEXACETONIDE

Objective. To determine the effectiveness of intrasynovial triamcinolo ne hexacetonide coupled with joint rest (3 weeks upper extremity; 6 we eks lower extremity) in the treatment of joint and tendon sheath infla mmation in patients with seropositive rheumatoid arthritis (RA). Metho ds. The medical records of 169 patients with seropositive RA treated b y a single rheumatologist for at least one year between 1974 and 1992 were abstracted. Results. Nine hundred fifty-six injections were given to 140 patients; similar to 75% of injected synovial structures remai ned in remission during a mean followup 7 years; 218 injections were g iven into previously treated structures. The injection rate was about 2 per patient in the first year, half of which were given at the time of the first visit. The rate then approximated 0.6 injections per pati ent-year for the next 15 years. Joints in the right upper extremity we re injected significantly (p = 0.01) more frequently than those on the left. Conclusion. Intrasynovial triamcinolone hexacetonide followed b y rest is a very useful adjunctive modality in the treatment of seropo sitive rheumatoid arthritis.