Abstract

Aim: Comparative evaluation of direct current and steroid iontophoresis treatments in patients with active wrist synovitis with rheumatoid arthritis.
Material and Methods: Rheumatoid arthritis (RA) is a chronic, inflammatory disease that causes pain, swelling and limitation of motion, keeping wrist and hand joints symmetrical. In this study, we examined the efficacy of steroid iontophoresis with direct current to the wrists of active RA patients. 20 active patients with RA and wrist synovitis were included in the study. Steroid iontophoresis applied in one wrist of these patients, direct current to the other wrist (control). Patients’ number of painful joints (NPJ), number of swollen joints (SJN), hand grip strength (HG), lateral grip strength (LG), Hand Functional Evaluation (HFE), Health Assessment Questionnaire (HAQ), Disease Activity Score-28 (DAS-28) and power Doppler ultrasonography (PDUS) were compared.
Results: Clinical and laboratory parameters were significantly improved according to pre-treatment (Pr-T) and post-treatment (Pst-T). We found significant improvement in Pr-T and Pst-T in the cases of HG, LG, HFE, SJN and NPJ in the wrist in treatment and control, but there was no significant difference between the control wrist and the treated wrist. There were no changes in Pr-T and Pst-T in grades, if any, resistive index (RI) and pulsatility index (PI) values of PDUS with pannus and current in hand wrist.
Conclusions: Our results showed no difference between the steroid iontophoresis and direct current therapy in patients with RA who were active and have wrist synovitis in Pr-T and Pst-T.

Key words: Rheumatoid Arthritis; Steroid Iontophoresis; Direct Current; Power Doppler Ultrasonography.