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Periarticular corticosteroid treatment of the sacroiliac joint in patients with seronegative spondylarthropathy.

OBJECTIVE
To evaluate the efficacy of periarticular corticosteroid injection of the sacroiliac joint (SIJ) in patients with seronegative spondylarthropathy in a double blind, controlled study.


METHODS
20 patients with seronegative spondylarthropathy and clinical sacroiliitis entered the study. In 10 patients one affected SIJ was treated with periarticular injection of 1.5 ml (40 mg/ml) methylprednisoloneacetate and 1.5 ml (20 mg/ml) lignocaine (MP group), whereas 10 patients received 1.5 ml isotonic sodium chloride and 1.5 ml (20 mg/ml) lignocaine (non-MP group). Clinical assessment at the onset of the study and after two months follow-up included the patients' estimation of pain in the SIJ by the visual analogue scale (VAS) and by a pain index which was calculated from tenderness and stressing tests on the SIJ.


RESULTS
At the two months follow-up examination the VAS (p = 0.02) and the pain index (p = 0.01) had improved significantly in the MP group compared with the non-MP group.


CONCLUSION
The results of our study indicate that the periarticular injection of methylprednisolone may be effective in the treatment of clinical sacroiliitis in patients with seronegative spondylarthropathy.