Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion

PLoS One. 2018 Jan 19;13(1):e0191342. doi: 10.1371/journal.pone.0191342. eCollection 2018.

Abstract

Objectives: Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion.

Methods: One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VAS<40mm.

Results: One hundred and thirty-two patients were included.A significant number of patients (61.4%) improved pain at one year following the protocol established in this study. Pain and ultrasound synovial fluid at one month appeared to predict the response at one year. The Lequesne index and the percentage of body fat were independently associated to pain at one year while the Lequesne index and ultrasound synovial hypertrophy were independently related to the presence of synovial fluid at one year.

Conclusions: The status regarding pain or ultrasound synovial fluid at one month after an intraarticular joint injection appeared to predict the status at one year in patients with knee osteoarthritis and synovial effusion.

Publication types

  • Observational Study

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Aged
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / drug therapy*
  • Osteoarthritis, Knee / physiopathology
  • Pain / drug therapy
  • Pain Management
  • Pain Measurement
  • Prospective Studies
  • Synovial Fluid / diagnostic imaging
  • Synovial Fluid / drug effects
  • Ultrasonography

Substances

  • Adrenal Cortex Hormones

Grants and funding

The authors received no specific funding for this work.