Response of symptoms and synovitis to intra-muscular methylprednisolone in osteoarthritis of the hand: an ultrasonographic study

Rheumatology (Oxford). 2010 Jun;49(6):1093-100. doi: 10.1093/rheumatology/keq010. Epub 2010 Mar 10.


Objective: To examine the relationship between ultrasound (US)-detected synovial pathology in hand OA and the clinical response to parenteral corticosteroids.

Methods: People with symptomatic OA of the hand completed questionnaires [visual analogue scale (VAS) pain, Australian Canadian Osteoarthritis Hand Index and VAS global] and underwent an US examination of both hands prior to receiving an i.m. dose of methylprednisolone. Four- and twelve-week assessments were performed to assess therapeutic response.

Results: Thirty-six subjects with established OA were enrolled. Twenty-four (67%) subjects met the primary end-point of a 20% reduction in VAS pain, 25 (69.4%) met the Osteoarthritis Research Society International response criteria at 4 weeks. Overall in the group, there was a reduction in levels of pain in the most painful joint, pain in all joints and in global disease activity at 4 weeks (P < 0.001, P < 0.001 and P < 0.001, respectively). Reduction in symptoms was not associated with a statistically significant reduction in US-detected synovial hypertrophy or power Doppler signal.

Conclusions: In this observational study, parenteral corticosteroids were associated with a statistically significant reduction in symptoms, but no statistically significant reduction in US-detected synovial inflammation. The latter finding may, however, reflect the relatively low levels of synovial inflammation detected ultrasonagraphically in hand joints.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Aged
  • Anti-Inflammatory Agents / administration & dosage*
  • Female
  • Hand / diagnostic imaging
  • Hand Joints / diagnostic imaging*
  • Humans
  • Injections, Intramuscular
  • Male
  • Methylprednisolone / administration & dosage*
  • Middle Aged
  • Osteoarthritis / diagnostic imaging*
  • Osteoarthritis / drug therapy
  • Pain
  • Severity of Illness Index
  • Statistics as Topic
  • Surveys and Questionnaires
  • Synovitis / diagnostic imaging*
  • Synovitis / drug therapy
  • Ultrasonography


  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Methylprednisolone