US guided steroid injection in sternal region in patients with spondyloarthropathy.
US guided steroid injection in sternal region in patients with spondyloarthropathy.
Biernat-Kałuża E., Czyrny Z, Bień M
Praca zaprezentowana przez podczas IV Kongresu nt. Spondyloartropatii, 7-9.X. 2004, Gent, Belgia oraz opublikowana w„Clinical and Experimental Rheumatology” vol.22 no.5, 2004.
BACKGROUND: Inflammation of sternoclavicular joints and/or sternal syndesmosis in the course of SAPHO and other seronegative spondyloarthropathy is quite often a problem in clinical practice. Management of arthritis and /or syndesmositis detected by high resolution ultrasound (US) examination, with US guided steroid injection might be a useful therapeutic tool.
OBJECTIVES: To present usefulness of US needle guided steroid injection in the treatment of patients with sternoclavicular arthritis and peristernal area.
METHODS: Group of 10 patients who fulfilled Amor and/or ESSG criteria for spondyloarthropathy and sufferred from sternal region inflammation in the course of seronegative spondyloarthropathy, consisted of 8 female and 2 male at age from 22 till 40 years (mean 29,1yrs). Antigen HLA B27 was examined in 4 persons, and was found in 4 of them (2 men with ankylosing spondylitis and 2 women with undifferentiated spondyloarthropathy) Painful area was examined with high resolution US machine equipped with linear array transducer 8-12MHz and Power Doppler. In all persons arthritis of sternoclavicular joints and/or sternal syndesmosis were found. Later, US guided steroid (Diprophos, Schering Plough) injection was performed.
RESULTS: Two weeks after injection the control ultrasound examination was carried out. In all patients, arthritis reduction or total remission was stated.
CONCLUSIONS: High resolution US guided needle puncture and steroid injection is a very useful therapeutic tool in the treatment arthritis and/or syndesmositis of sternal area in spondyloarthropatic patients.
Close cooperation between clinical and diagnostic medical departments allows for establishment of concise diagnosis and effective treatment.
REFERENCES: W.Grassi, A.Farina, E. Filippucci, C.Cervivi: Sonographically Guided Procedures in Rheumatology; Seminars in Arthritis and Rheumatism 2001; 30(5) 347-353
