Efficacy of sacroiliac corticosteroid injections in patients with inflammatory spondyloarthropathy: results of a 6 month controlled study.

Abstract

OBJECTIVE:

To evaluate changes in articular symptoms, spinal mobility, and global function over 6 months after intraarticular injections of long acting corticosteroid into the sacroiliac (SI) joints of patients with inflammatory low back pain (ILBP).

METHODS:

Nineteen patients with symptoms of ILBP were studied. Thirteen (68%) had radiographic evidence of sacroiliitis. The remaining 6 patients (32%) had normal imaging studies and thus were considered to have mechanical low back pain. All patients received bilateral SI joint injections of triamcinolone hexacetonide (40 mg/joint) under computer tomographic guidance. Outcome variables included the duration of low back morning stiffness, back pain (by visual analog scale, McGill Pain Questionnaire), spinal mobility (chest expansion, Schober test, 10 cm segments test, finger-fibula distance), and self-report health status (SF-36).

RESULTS:

Both groups of patients showed a transient improvement in stiffness and pain, spinal mobility, and general health status that was most pronounced at 1-3 months after intraarticular therapy. This did not reach statistical significance (p > 0.05) and by 6 months, followup all outcome variables had reverted to pretherapy levels in both groups.

CONCLUSION:

These preliminary observations suggest that SI corticosteroid injections are ineffective in the management of patients with inflammatory spondyloarthropathy.

• Authors: J G Hanly, M Mitchell, L MacMillan, D Mosher, E Sutton
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 27 Issue 3 Pg. 719-22 (Mar 2000) ISSN: 0315-162X [Print] Canada
• PMID: 10743815 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Triamcinolone Acetonide
• triamcinolone hexacetonide

Topics

• Administration, Topical
• Adult
• Anti-Inflammatory Agents (administration & dosage, therapeutic use)
• Back Pain (drug therapy, physiopathology)
• Female
• Health Status
• Humans
• Injections, Intra-Articular (methods)
• Male
• Range of Motion, Articular (drug effects)
• Sacroiliac Joint (diagnostic imaging, drug effects)
• Spondylitis (drug therapy, physiopathology)
• Tomography, X-Ray Computed
• Triamcinolone Acetonide (administration & dosage, analogs & derivatives, therapeutic use)