Different effects of local cryogel and cold air physical therapy in wrist rheumatoid arthritis visualised by power Doppler ultrasound

K Albrecht¹, C Albert¹, U Lange¹, U Müller-Ladner¹, J Strunk²

¹ University of Giessen, Department of Rheumatology and Immunology, Kerckhoff Klinik, Bad Nauheim, Germany
² Krankenhaus Porz am Rhein, Köln, Germany

Correspondence to:
Dr K Albrecht, University of Giessen, Department of Rheumatology and Immunology, Kerckhoff Klinik, Benekestr.2-8, 61231 Bad Nauheim, Germany; katinkaalbrecht@yahoo.de

Accepted 5 October 2008

The first 150 words of the full text of this article appear below.

Cold is applied in arthritic joints to reduce the inflammatory activity of matrix-degrading enzymes and to ameliorate pain. The effect is based on vasoconstriction, leading to a downregulation of metabolic pathways. An analgesic component can be achieved after short-term cryotherapy by destimulating pain receptors in the cutis. Antiphlogistic effects are achieved after long-term cold treatment by inhibiting the metabolism in the inflammatory cells and repressing the release of lysosomal enzymes.¹

Evaluation of the effect inside the joint is impossible without objective measurements. However, published reports are limited to clinical assessment, such as pain and disease activity scores.^{2 3} A reduction of blood flow has been reported in Achilles tendinopathy using laser-Doppler spectrophotometry.⁴ Alterations of synovial perfusion have been demonstrated with power Doppler ultrasound (PDUS).⁵ The aim of this study was to compare the effects of short- and long-term cryotherapy on synovial vasoconstriction with PDUS. Twenty-five patients with rheumatoid arthritis and wrist . . . [Full text of this article]

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