2016 Volume 40 Issue 2 Pages 131-136
Objective: The guidelines for the management of hyperuricemia and gout recommend that gouty patients with arthritis with effusion in the knee and elbow joints are injected corticosteroids after the removal of the effusion. However, the therapeutic effect in gouty patients with metatarsophalangeal (MTP) arthritis is not known. The purpose of this study was to examine the effect of ultrasound-guided steroid injection into the MTP joint.
Patients and Methods: From seventeen patients, twenty MTP joints with acute gouty attack were included in this study. All patients were male, and the average age was 55.6 years old. The number of the first MTP joints was 18 and that of the second MTP joints was 2. After checking the long axis sonogram of the MTP joint, ultrasound-guided steroid injection using a 27-gauge needle was performed with an out-of-plane approach. Successful injections were confirmed by the needle tip or steroid flow into the MTP joint. Either triamcinolone acetonide 8-14 mg (0.2-0.35 mL) or dexamethasone sodium phosphate 1.65-3.3 mg (1.0-2.0 mL) was injected. The success rate of the ultrasoundguided injection and time-course of pain relief were evaluated.
Results: The success rate of the ultrasound-guided injection into the MTP joint was 100%. Pain relief was observed in 50% OF joints within 24 hours after injection, in 65% OF joints within 2 days, and finally in 95% OF joints within 4 days.
Conclusion: The results suggest that ultrasoundguided steroid injection into the MTP joint is a very useful method to treat acute gouty attack.
