Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study

Akihiro Fukui; Hideki Yamada; Takashi Yoshii

doi:doi:10.11648/j.js.20210904.13

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Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study

Akihiro Fukui, Hideki Yamada, Takashi Yoshii

Published in Journal of Surgery (Volume 9, Issue 4)

Received: 15 May 2021 Accepted: 3 June 2021 Published: 15 June 2021

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Abstract

Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.

Published in	Journal of Surgery (Volume 9, Issue 4)
DOI	10.11648/j.js.20210904.13
Page(s)	159-165
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

RA, Wrist, Joint Pain, Steroid Injection

References

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[11]	Hetland ML, Stengaard-Pedersen K, et al. CIMESTRA study group. Aggressive combination therapy with intra-articular glucocorticoid injections and conventional disease-modifying anti-rheumatic drugs in early rheumatoid arthritis: second-year clinical and radiographic results from the CIMESTRA study. Ann Rheum Dis. 2008 Jun; 67 (6): 815-22.
[12]	Hetland ML, ?stergaard M, Ejbjerg B, et al. CIMESTRA study group. Short and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis: impact of joint area, repeated injections, MRI findings, anti-CCP, IgM-RF and CRP. Ann Rheum Dis. 2012 Jun; 71 (6): 851-6.
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[14]	Fukui A, Yamada H, Yoshii Y. Effect of intra-articular injection of triamcinolone acetonide for wrist pain in rheumatoid arthritis patients. A statistical investigation. J Hand Surg (Asian-Pacific volume). 2016, 2 (12): 239-245.
[15]	Bodick N, Lufkin J, Willwerth C, et al. An intra-articular extended-release formulation of triamcinolone acetonide prolongs and amplifies analgesic effect in patients with osteoarthritis of the knee: a randomized clinical trial. J Bone Joint Surg Am. 2015 Jun 3; 97 (11): 877-88.
[16]	Kumar A, Bendele AM, Blanks RC, et al. Sustained efficacy of a single intra-articular dose of FX006 in a rat model of repeated localized knee arthritis Osteoarthritis Cartilage. 2015 Jan: 23 (1): 151-60.
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APA Style

Akihiro Fukui, Hideki Yamada, Takashi Yoshii. (2021). Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study. Journal of Surgery, 9(4), 159-165. https://doi.org/10.11648/j.js.20210904.13

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ACS Style

Akihiro Fukui; Hideki Yamada; Takashi Yoshii. Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study. J. Surg. 2021, 9(4), 159-165. doi: 10.11648/j.js.20210904.13

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AMA Style

Akihiro Fukui, Hideki Yamada, Takashi Yoshii. Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study. J Surg. 2021;9(4):159-165. doi: 10.11648/j.js.20210904.13

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@article{10.11648/j.js.20210904.13,
  author = {Akihiro Fukui and Hideki Yamada and Takashi Yoshii},
  title = {Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study},
  journal = {Journal of Surgery},
  volume = {9},
  number = {4},
  pages = {159-165},
  doi = {10.11648/j.js.20210904.13},
  url = {https://doi.org/10.11648/j.js.20210904.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210904.13},
  abstract = {Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.},
 year = {2021}
}

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TY  - JOUR
T1  - Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study
AU  - Akihiro Fukui
AU  - Hideki Yamada
AU  - Takashi Yoshii
Y1  - 2021/06/15
PY  - 2021
N1  - https://doi.org/10.11648/j.js.20210904.13
DO  - 10.11648/j.js.20210904.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 159
EP  - 165
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20210904.13
AB  - Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.
VL  - 9
IS  - 4
ER  -

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Author Information

Akihiro Fukui

Department of Orthopedic Surgery, Nishinokyo Hospital, Nara, Japan
Hideki Yamada

Department of Internal Medicine, Nijo-Ekimae Clinic, Nara, Japan
Takashi Yoshii

Department of Orthopedic Surgery, Saiseikai Chuwa Hospital, Nara, Japan

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APA Style

Akihiro Fukui, Hideki Yamada, Takashi Yoshii. (2021). Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study. Journal of Surgery, 9(4), 159-165. https://doi.org/10.11648/j.js.20210904.13

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ACS Style

Akihiro Fukui; Hideki Yamada; Takashi Yoshii. Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study. J. Surg. 2021, 9(4), 159-165. doi: 10.11648/j.js.20210904.13

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AMA Style

Akihiro Fukui, Hideki Yamada, Takashi Yoshii. Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study. J Surg. 2021;9(4):159-165. doi: 10.11648/j.js.20210904.13

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@article{10.11648/j.js.20210904.13,
  author = {Akihiro Fukui and Hideki Yamada and Takashi Yoshii},
  title = {Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study},
  journal = {Journal of Surgery},
  volume = {9},
  number = {4},
  pages = {159-165},
  doi = {10.11648/j.js.20210904.13},
  url = {https://doi.org/10.11648/j.js.20210904.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210904.13},
  abstract = {Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.},
 year = {2021}
}

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TY  - JOUR
T1  - Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study
AU  - Akihiro Fukui
AU  - Hideki Yamada
AU  - Takashi Yoshii
Y1  - 2021/06/15
PY  - 2021
N1  - https://doi.org/10.11648/j.js.20210904.13
DO  - 10.11648/j.js.20210904.13
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 159
EP  - 165
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20210904.13
AB  - Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.
VL  - 9
IS  - 4
ER  -

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