US-guided interventional joint procedures in patients with rheumatic diseases--...

• Author(s): Gonçalves, B ; Ambrósio, C ; Serra, S ; Alves, F ; Gil-Agostinho, A ; Caseiro-Alves, F
• Date: 2011
• Persistent ID: http://hdl.handle.net/10400.4/1109
• Origin: Repositório do Centro Hospitalar e Universitário de Coimbra
• Subject(s): Doenças Reumáticas; Ultrassonografia
• Document Type: Article
• Language: English

Description

OBJECTIVE: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. MATERIALS AND METHODS: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n=11) had rheumatoid arthritis, 11% (n=3) spondyloarthropathies, 18% (n=5) psoriatic arthritis, 15% (n=4) undifferentiated arthritis, 3% (n=1) Sjögren syndrome and 11% (n=3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. RESULTS: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. CONCLUSIONS: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.