Joint, bone, spine : revue du rhumatisme
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Many patients with gouty arthritis experience frequent flares and have comorbidities that may limit their anti-inflammatory treatment options for acute flare management. For patients with contraindications to both NSAIDs and/or colchicine, treatment options are particularly limited, and there is an unmet medical need in this subgroup of patients. ⋯ Canakinumab was consistently superior to the active comparator triamcinolone acetonide and was generally well tolerated in this patient population with a high prevalence of multiple medical comorbidities. Canakinumab should therefore be considered as a treatment option in a target population of patients with frequent gouty arthritis attacks who are unable to use NSAIDs and colchicine and in whom frequent use of corticosteroids is not considered appropriate.
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Review Meta Analysis
Intra-articular injections in thumb osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.
The objective was to assess the efficacy of intra-articular injections of corticosteroids or hyaluronic acid in thumb osteoarthritis. ⋯ This meta-analysis shows great heterogeneity. Hyaluronic acid may be useful to increase functional capacity and corticosteroids to decrease pain in thumb osteoarthritis at week 24.
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Randomized Controlled Trial
Usefulness of a pre-procedure ultrasound scanning of the lumbar spine before epidural injection in patients with a presumed difficult puncture: A randomized controlled trial.
Ultrasound (US) is widely used in rheumatology to study and guide injection of peripheral joints. It can also provide useful information about the anatomy of the lumbar spine. Studies have shown that US examination of the spine was a useful tool to help perform epidural anaesthesia. The purpose of the study was to determine if the selection of the optimum puncture level by US may facilitate epidural steroid injection in case of presumed difficult puncture (BMI>30 kg/m(2), age>60 years or lumbar scoliosis). ⋯ US of the lumbar spine was feasible in patients with lumbar conditions even in obese and old ones and allowed the visualization of the epidural space. However, pre-procedure US examination did not reduce pain during the procedure.