ABSTRACT
Objective: The objective of this study was to compare the improvement in hand function and disease activity among patientsreceiving intra-articular with intramuscular depot methylprednisolone injections.Design: A prospective cohort of 136 patients with rheumatoid arthritis were randomly allocated in two parallel groups (IA and IM)who were given depot methylprednisolone injection either intraarticularly or intramuscularly after assessment of wrist ROM,grip strength, CDAI and KFT scores on 1st visit and reassessed at 1 month and 3 months post-injection.Results: Wrist flexion and extension, power grip and all pinch grips of both hands have shown statistically significant improvementover time between any two visits, except right wrist extension, right and left lateral pinch grip did not have statistically significantimprovement between 2nd and 3rd visits. CDAI scores reduced and KFT scores improved in persistent manner more in IM groupover time between any two visits which are statistically significant. It is also seen that with decrease in disease activity there isimprovement of functional ability in the subjects.Conclusions: Intra-articular injections have sustained effects throughout the study period in ROM improvement, and intramuscularinjections have short-lived effects and are more effective in improving outcomes of functional status and disease activity
ABSTRACT
Introduction: Patients with rheumatoid arthritis (RA) who are positive for anti-cyclic citrullinated peptide (CCP)/rheumatoidfactor (RF) have more extra-articular manifestations.Purpose: We tried to evaluate the magnitude of ocular manifestations in RA patients and to find out whether there is anycorrelation of anti-CCP or RF or disease duration to ocular involvement.Materials and Methods: A total of 288 patients diagnosed as RA with ocular symptoms were evaluated. Drug-induced effectsand cataract were excluded from the study.Results: About 18.1% were male and 81.9% were female. The minimum age was 21 and the maximum was 80 years. Theaverage age was 45.66 years. About 36.8% of patients had ocular manifestations. They were bilateral in 66% of patients.Multiple ocular manifestations were shown in 60.4% of patients. Dry eye was observed in 30.5%, anterior uveitis in 6.25%, andepiscleritis and scleritis in 7.6% each. Anti-CCP was present in 86.8% and RF in 78.5% of patients. The duration of diseasewas found to be statistically significant with respect to the presentation of ocular manifestations. Anti-CCP was found to bestatistically significant with respect to ocular manifestations but statistically insignificant in case of RF. No statistical significancewas found between gender and ocular manifestations.Conclusion: So far, no published Indian study with such large number of patients looked at ocular manifestations of RA correlatingwith disease duration and impact of both anti-CCP and RF at the same time. Our study indicates that patients suffering fromRA with anti-CCP positivity and long duration of disease should be evaluated ophthalmologically.