Intra-Articular Glucocorticosteroid Injection into Sternocostoclavicular Joints in Patients with SAPHO Syndrome

Seminars in Arthritis and Rheumatism, 05/08/2012

Jung J et al. – Intra–articular glucocorticosteroid instillation does not appear to reduce osteitis in the sternocostoclavicular region in patients with SAPHO syndrome.

Methods

  • Ten patients with SAPHO syndrome and symptomatic osteitis in the sternocostoclavicular region were treated by a single instillation of glucocorticosteroids (20 mg triamcinolone) into the sternocostoclavicular joints.
  • The disease activity was evaluated on the basis of a questionnaire asking for osteitis activity (quantified for complains on a scale of 0–6), by Health Assessment Questionnaire (HAQ) score, erythrocyte sedimentation rate, C–reactive protein, and magnet resonance imaging (MRI) scanning of the sternocostoclavicular region (osteitis scores quantified for inflammation on a scale of 0–2 by the radiologist) prior to injection and after 12 weeks.
  • No changes of the preexisting antirheumatic therapy were allowed during the observation interval.

Results

  • All patients continued the study during the follow–up.
  • The osteitis score changed from 4.2 (mean; standard error (SE)±0.3) to 3.2 (±0.4), [P = 0.062], the erythrocyte sedimentation rate from 19.0 (range from 12 to 30) to 19.9 (from 12 to 27), [P = 0.430], and the MRI score from 1.6 (±0.2) to 1.5 (±0.2) [P = 1.0].
  • One patient developed an increase of the clinical osteitis activity from 3 to 5 according the scoring system; only 2 patients showed a reduction of the MRI activity score from 2 to 1.

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