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Ann Rheum Dis. 2004 June; 63(6): 740–743.
PMCID: PMC1755043

Grey scale and power Doppler sonographic changes induced by intra-articular steroid injection treatment


Methods: 20 patients with clinically active synovitis of a small joint unresponsive to systemic drug treatment underwent a sonographic guided intralesional injection with triamcinolone acetonide. Clinical examinations were carried out by a trained rheumatologist. GSS and PDS examinations were performed independently by two examiners unaware of the results of the clinical examination. Joint cavity widening and power Doppler signal were evaluated and graded on a semiquantitative scale ranging from 1 to 4. Clinical and sonographic follow up examinations were carried out 2 weeks after the injection with triamcinolone acetonide.

Results: All intra-articular injections were successfully carried out and documented under sonographic guidance. In 19/20 patients, baseline sonographic examinations clearly detected morphological and perfusional signs of synovitis. At follow up examinations, clinical and sonographic scores had improved significantly.

Conclusion: GSS and PDS appear to be a useful adjunctive tool for assessing short term soft tissue changes induced by intra-articular injection treatment with triamcinolone acetonide in small joints of patients with chronic arthritis.

Figure 1
(A, B) Baseline ultrasound examination on longitudinal dorsal scan of the wrist joint of an 82 year old patient with rheumatoid arthritis (patient number 4). An intra-articular injection of triamcinolone acetonide (30 mg) was performed under sonographic ...
Figure 2
A 30 year old patient with psoriatic arthritis (patient number 17) presented at baseline clinical examination with a severe pain of the distal interphalangeal joint of his left second finger (VAS score 8; tenderness score 3). At follow up clinical examination ...

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