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Rheumatology Advance Access published online on March 30, 2004
Rheumatology, doi:10.1093/rheumatology/keh181
Rheumatology © British Society for Rheumatology 2004; all rights reserved
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© 2004 British Society for Rheumatology; all rights reserved

Original Papers

Intra-articular methotrexate in knee synovitis

N. Hasso 1, P. J. Maddison 1*, and A. Breslin 1

1 Department of Rheumatology, Ysbyty Gwynedd, Bangor, Wales, UK

* Corresponding author. E-mail: peter.maddison{at}nww-tr.wales.nhs.uk.

Received 20 September 2003 ; accepted 17 February 2004

Abstract

Objective. To test whether methotrexate prolongs the effect of intra-articular corticosteroid in suppressing knee synovitis.

Methods. Thirty-eight patients with chronic knee synovitis were randomly allocated to receive intra-articular triamcinolone hexacetonide with or without methotrexate. Variables were knee pain and swelling, assessor and patient global assessment, morning stiffness, ESR and CRP. The primary endpoint was the duration of improvement.

Results. After treatment, both groups of patients demonstrated a significant improvement in all variables. However, there was no significant difference between the two groups in the degree or duration of the response. No side-effects were encountered with methotrexate apart from a slight elevation of transaminase levels in some patients.

Conclusions. In the context of this study, the addition of methotrexate to triamcinolone did not add significantly to the clinical response to intra-articular corticosteroid in chronic knee synovitis. However, further controlled studies using different designs are probably warranted.


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