Effects of joint lavage on knee synovitis in rheumatoid arthritis

Ten patients with rheumatoid arthritis and persistent knee synovitis had synovial fluid aspirated through a 14 gauge wide-bore needle followed by joint lavage and intra-articular triamcinolone. This resulted in the removal of variable quantities of intra-articular debris including rice bodies. When compared to a control group of patients, the addition of joint lavage to the standard procedure of aspiration and injection of corticosteroid resulted in more sustained resolution of synovitis after 12 weeks as judged by knee tenderness and circumference, recurrence of effusion, and synovial fluid leucocyte count. This study suggests that knee joint lavage may be a useful adjunct to therapy in rheumatoid arthritis patients having persistent knee synovitis.