[Local joint treatment in chronic polyarthritis: intra-articular corticosteroids and radioactive isotopes]. 1993

M Weber
Klinik für Rheumatologie und Rehabilitation, Stadtspital Triemli, Zürich.

Intrasynovial injection of corticosteroids is currently one of the routine measures in the treatment of patients with rheumatoid arthritis. Crystalline corticosteroid suspensions have proved their value and are effective for approximately one to three weeks. One or two injections can control synovitis for prolonged periods of time. Special attention has to be given to impeccable technique of instillation. However, it must be kept in mind that, within the overall management of rheumatoid arthritis, the intra-articular injection of corticosteroids is a local, palliative and temporary measure. The intrasynovial instillation of radionuclides is used only in selected cases. Therapy of the knee joint is mainly performed with Yttrium-90, less frequently, the interphalangeal joints are treated with Erbium-169. Costs and radiation exposure are low, but a favourable result is only achieved in slightly more than 50 per cent of cases. This review provides a synopsis of the basic concepts and practical applications of intrasynovial corticosteroid and radioisotope injection therapy.

UI MeSH Term Description Entries
D007270 Injections, Intra-Articular Methods of delivering drugs into a joint space. Intra Articular Injection,Intraarticular Injection,Injections, Intraarticular,Intra-Articular Injections,Intraarticular Injections,Articular Injection, Intra,Articular Injections, Intra,Injection, Intra Articular,Injection, Intra-Articular,Injection, Intraarticular,Injections, Intra Articular,Intra Articular Injections,Intra-Articular Injection
D011868 Radioisotopes Isotopes that exhibit radioactivity and undergo radioactive decay. (From Grant & Hackh's Chemical Dictionary, 5th ed & McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Daughter Isotope,Daughter Nuclide,Radioactive Isotope,Radioactive Isotopes,Radiogenic Isotope,Radioisotope,Radionuclide,Radionuclides,Daughter Nuclides,Daugter Isotopes,Radiogenic Isotopes,Isotope, Daughter,Isotope, Radioactive,Isotope, Radiogenic,Isotopes, Daugter,Isotopes, Radioactive,Isotopes, Radiogenic,Nuclide, Daughter,Nuclides, Daughter
D005938 Glucocorticoids A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075202 Contraindications A condition or factor associated with a recipient that makes the use of a drug, procedure, or physical agent improper or inadvisable. Contraindications may be absolute (life threatening) or relative (higher risk of complications in which benefits may outweigh risks). Contraindications, Physical Agent,Medical Contraindications,Agent Contraindication, Physical,Agent Contraindications, Physical,Contraindication,Contraindication, Medical,Contraindication, Physical Agent,Contraindications, Medical,Medical Contraindication,Physical Agent Contraindication,Physical Agent Contraindications
D000287 Administration, Topical The application of drug preparations to the surfaces of the body, especially the skin (ADMINISTRATION, CUTANEOUS) or mucous membranes. This method of treatment is used to avoid systemic side effects when high doses are required at a localized area or as an alternative systemic administration route, to avoid hepatic processing for example. Drug Administration, Topical,Administration, Topical Drug,Topical Administration,Topical Drug Administration,Administrations, Topical,Administrations, Topical Drug,Drug Administrations, Topical,Topical Administrations,Topical Drug Administrations
D000893 Anti-Inflammatory Agents Substances that reduce or suppress INFLAMMATION. Anti-Inflammatory Agent,Antiinflammatory Agent,Agents, Anti-Inflammatory,Agents, Antiinflammatory,Anti-Inflammatories,Antiinflammatories,Antiinflammatory Agents,Agent, Anti-Inflammatory,Agent, Antiinflammatory,Agents, Anti Inflammatory,Anti Inflammatories,Anti Inflammatory Agent,Anti Inflammatory Agents
D001172 Arthritis, Rheumatoid A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated. Rheumatoid Arthritis
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