The response to intra-articular steroid injections in patients with osteoarthritis of the knee: Sonographic versus palpation technique

Abstract

Background: Osteoarthritis is the most common chronic joint disease globally, intra articular  steroid injection (IASI) is an option of  treatment but has a huge variation in the response and  duration of response. One of the reasons proposed for this variation is the extra-articular deposition of the steroid. This study is aimed at determining if there is any difference in response from traditional palpation-guided technique from the sonographic-guided technique.

Method: Fifty-four patients aged 30 to 80 years who have been diagnosed of osteoarthritis using American College of Rheumatology criteria, and have met the inclusion criteria were enrolled in the study. They were randomly divided into two cohort groups and had intra articular steroid injections into the knee either by palpation or sonographic-guided technique.

Results: The median age of the participants was 53.5 ± 10.1 years, there was a predominance of females, there was no significant difference between the sonography group and the traditional palpation technique group except in alcohol consumption with p-value of 0.025. In this study, palpation-guided methods responders are similar with the relative value of responders for the sonographic-guided  method, 76.9% and 81.9%, respectively in 2 weeks using WOMAC  score and 100% each using the VAS score. The WOMAC score in the  group that had IASI under  sonography had better pain reduction as seen in Figure 1, but the difference in response between  the two  groups was not statistically different.

Conclusion: In conclusion, palpation-guided intra articular steroid injection response is like the  response from sonographic-guided intra  articular steroid injection.