Ultrasound-guided local injection in treatment of hand and wrist tenosynovitis in patients with rheumatoid arthritis / 中国医学影像技术

ABSTRACT

Objective: To explore the clinical efficacy of ultrasound-guided local injection in treatment of rheumatoid arthritis (RA) patients with hand and wrist tenosynovitis. Methods: Totally 62 RA patients with hand and wrist tenosynovitis were randomly divided into ultrasound-guided injection (USGI) group (n=37) and conventional blind injection (CBI) group (n=25) and underwent USGI or CBI of betamethasone and lidocaine mixture, respectively. The ratio of adverse effect during the therapeutic process was compared between the two groups. Before treatment and 2, 4 and 12 weeks after treatment, the pain visual analogue scale (VAS), disease activity score in 28 joints (DAS28), gray scale ultrasound (GSUS) and power Doppler ultrasound (PDUS) scores, as well as therapeutic efficiency were compared between the two groups. Results: The ratio of adverse effect of USGI group was 2.70% (1/37), lower than that of CBI group (5/20, 20.00%; P=0.03). VAS and DAS28 scores of USGI group 4 and 12 weeks after treatment were lower than those in CBI group (all P<0.01). PDUS scores of USGI group 2, 4 and 12 weeks after treatment were lower than those in CBI group (all P<0.01), respectively, while GSUS score of USGI group was lower than that of CBI group 12 weeks after treatment (P<0.01). The efficiency of USGI group 4 and 12 weeks after treatment was higher than that in CBI group (both P<0.05). Conclusion: Ultrasound-guided local injection is safe and efficient in treatment of RA patients with hand and wrist tenosynovitis.