Treatment of rheumatoid hand synovitis with a regional block technique
This study reports a novel technique for treating painful rheumatoid hand synovitis using a regional block techique.
Nine patients with symptomatic rheumatoid hand synovitis were treated. Assessments of symptoms, grip strength and synovial swelling were made in each hand before the injection, and at 1 and 4 weeks after the procedure. A sphygmomanometer cuff was inflated, on the side of the patients most symptomatic hand, to 220mmHg and a solution of hydrocortisone sodium succinate 50mgs and lignocaine 10mls 0.5% was injected intravenously. The cuff was deflated slowly after 20 minutes.
The injected hand improved symptomatically in 7 patients at 1 week, and further improvement was reported in 6 of these 7 at 1 month. Mean grip strength increased significantly in the injected hand both at 1 week (p=0.01) and 1 month (p=0.018). There was no change in the other hand.
This technique is safe, reduced hand pain and improved grip strength in these patients with rheumatoid hand synovitis.
KeywordsSynovitis Grip Strength Lignocaine Hand Function Measure Grip Strength
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Bier A. Ueber einen neun weq local anasthesie an den gliedmassen zu erzeugen. Archiv fur Klinische Chirugie 1908;86:1007–1112.Google Scholar
Solgard S., Kristiansen, Jensen J.S. Evaluation of instruments for measuring grip strength. Acta Orthop Scand 1984;55:569–73.CrossRefGoogle Scholar
Zeger S.L., Liang K.Y. Longitudinal data analysis for discrete and continuous outcomes. Biometrics 1986;42:121–130.PubMedCrossRefGoogle Scholar
Forster P.J.G., Grindulis K.A., Neumann V., Hubball S., McKonkey B. High-dose intravenous methylprednisolone in rheumatoid arthritis. Ann Rheum Dis 1982;41:444–6.PubMedCrossRefGoogle Scholar
Williams I.A., Baylis E.M., Shirley M.E. A double-blind placebo-controlled trial of methylprednisolone pulse therapy in active rheumatoid diseases. Lancet 1982;2:237–39.PubMedCrossRefGoogle Scholar
Gray R.G., Gottlieb N.L. Intra-articular corticosteroids. Clin Orthop 1983;177:235–63.PubMedGoogle Scholar
Jones E., Hanly J.G., Mooney R. et al. Strength and hand function in the normal and rheumatoid hand. J Rheumatol 1991;18:1313–8.PubMedGoogle Scholar
Jones L.A. The assessment of handfunction: Acriticalreview of techniques. J Hand Surg 1989;141:221–8.Google Scholar