PROSPECTIVE USE OF INTRAMUSCULAR TRIAMCINOLONE ACETONIDE IN PSEUDOGOUT

Objective, To prospectively assess the efficacy of intramuscular (im) triamcinolone acetonide in the treatment of pseudogout. Methods. Fourt een patients with crystal proven pseudogout presenting with an acute a ttack within 5 days of onset were treated with intramuscular triamcino lone acetonide 60 mg and followed for 30 days. Patients with inadequat e response were eligible for a 2nd triamcinolone acetonide injection o n Day 1-2. Results, Twelve patients had contraindication to nonsteroid al antiinflammatory agents (NSAID). Acute arthritis was monoarticular in 10 patients, and involved 2 or more joints in 4 patients. All patie nts had good clinical response to triamcinolone acetonide based on res toration of near baseline joint range of motion and joint circumferenc e, and at least 50% improvement in patient and physician global assess ment. Major clinical improvement occurred by Day 1-2 (2 patients), Day 3-4 (11 patients), and Day 10-14 (one patient). Six patients required a 2nd triamcinolone acetonide injection on Day 1-2. Toxicities were n ot observed. Conclusion. im triamcinolone acetonide appears to be safe , well tolerated, and effective in the treatment of pseudogout, It may be a reasonable alternative therapy when NSAID are contraindicated, a nd for polyarticular attacks where intraarticular corticosteroids are impractical.