Efficacy of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in rheumatoid arthritis

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Efficacy of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in rheumatoid arthritis

A recent study has shown an improvement in foot function and pain reduction with the use of hyaluronic acid (HA) injection.  Wang C, et al., performed a study to reveal whether HA injection into rheumatoid arthritis ankles and feet can achieve improvement in foot function and lessen synovial hyper-vascularization.

A total of 44 patients suffering from RA having unilateral or bilateral painful ankle and foot involvement (N = 75) were included in the study. All the patients were randomized to obtain HA (N = 40) or lidocaine (LI) (N = 35) injection at 2-week intervals. At baseline, 4 weeks (first evaluation) and 12 weeks (secondary evaluation), the clinical estimation was performed via a visual analog scale (VAS) and foot function index (FFItotal) including subscales of pain (FFIpain) before injection. The color Doppler ultrasound (CDUS) and synovitis scores were used for the imaging evaluation performed concurrently. At the first evaluation, HA injection improved the VAS score (p=0.009), FFIpain (p = 0.041), and FFItotal(p = 0.032) considerably more than lidocaine injections. At the first evaluation (p=0.005) and secondary evaluation (p<0.001), the CDUS values decreased notably compared with the base line values. The CDUS values of more than half of the joints (54%, p = .042) were reduced due to HA injections while the control group displayed no change (20%, p = .56). Although, HA injection did not decrease the CDUS values more than LI injection did. No noteworthy difference was observed between or within the groups in the synovitis scores concerning the evaluation of synovial hypertrophy.

Overall, HA injection may have a modest consequence in reducing synovial hyper-vascularization. Further large-scale studies are needed to confirm this outcome.

Source:

Modern rheumatology

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/28058962

The original title of the article:

Short-term effect of ultrasound-guided low-molecular-weight hyaluronic acid injection on clinical outcomes and imaging changes in patients with rheumatoid arthritis of the ankle and foot joints. A randomized controlled pilot trial

Authors

Chien-Chih Wang et al.

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