Changes in articular synovial lining volume measured by magnetic resonance in a randomized, double-blind, controlled trial of intra-articular samarium-153 particulate hydroxyapatite for chronic knee synovitis.

Abstract

OBJECTIVE:

Magnetic resonance techniques have recently been investigated as tools with which to monitor inflammatory joint disease. Our aim was to use a contrast-enhanced T1-weighted protocol to monitor the short-term changes in knee synovial lining volume in a double-blind, randomized, controlled trial of intra-articular samarium-153 particulate hydroxyapatite (Sm-153 PHYP).

METHODS:

Twenty-four out-patients with chronic knee synovitis, from a cohort who had been recruited to a long-term clinical efficacy trial, were recruited for this study. Patients received either intra-articular Sm-153 PHYP combined with 40 mg triamcinolone hexacetonide or 40 mg intra-articular triamcinolone hexacetonide alone. Synovial lining volumes were calculated from three-dimensional T1-weighted contrast-enhanced images made before and after contrast enhancement with thresholding and pixel counting, immediately before and 3 months after treatment.

RESULTS:

Paired pre- and post-treatment magnetic resonance data were obtained for 18/24 (75%) patients. There was no significant difference in mean pre-treatment synovial volume between the two treatment groups (139 vs 127 ml). A mean reduction in synovial lining volume was detected in the Sm-153 PHYP/steroid-treated group (139 to 110 ml, P = 0.07) and in the steroid-treated group (127 to 58 ml, P < 0.001). The reduction was significantly greater in the steroid-treated group (-61% vs -23%, P < 0.05).

CONCLUSIONS:

Short-term changes in articular synovial lining in response to intra-articular treatment for chronic synovitis may be monitored by magnetic resonance imaging. After 3 months, a greater mean reduction in synovial lining volume had occurred in response to intra-articular steroid alone compared to combined Sm-153 PHYP/steroid injection.

• Authors: G P Clunie, I D Wilkinson, D Lui, M A Hall-Craggs, M N Paley, J C Edwards, P J Ell
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 38 Issue 2 Pg. 113-7 (Feb 1999) ISSN: 1462-0324 [Print] England
• PMID: 10342622 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents
• Hydroxyapatites
• samarium hydroxyapatite
• Samarium
• Triamcinolone Acetonide
• triamcinolone hexacetonide

Topics

• Adult
• Anti-Inflammatory Agents (administration & dosage)
• Chronic Disease
• Double-Blind Method
• Female
• Humans
• Hydroxyapatites (administration & dosage)
• Knee (pathology, physiopathology)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Radiography
• Samarium (administration & dosage)
• Synovial Membrane (diagnostic imaging, pathology)
• Synovitis (diagnostic imaging, drug therapy, pathology)
• Triamcinolone Acetonide (administration & dosage, analogs & derivatives)