Comparison between Intra-articular and Intramuscular Depot Methylprednisolone Injection in Functional Improvement of Hand in Patients Suffering from Early Rheumatoid Arthritis

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