Ann Rheum Dis 64:1750-1753 doi:10.1136/ard.2004.035022
  • Extended report

Changes of cartilage and bone markers after intra-articular glucocorticoid treatment with and without postinjection rest in patients with rheumatoid arthritis

  1. T Weitoft1,
  2. A Larsson2,
  3. T Saxne3,
  4. L Rönnblom4
  1. 1Section of Rheumatology, Department of Internal Medicine, Gävle Hospital, Gävle, Sweden
  2. 2Department of Medical Science, Clinical Chemistry, Uppsala University Hospital, Uppsala, Sweden
  3. 3Department of Rheumatology, Lund University Hospital, Lund, Sweden
  4. 4Department of Medical Science, Section of Rheumatology, Uppsala University Hospital
  1. Correspondence to:
    Dr Tomas Weitoft
    Section of Rheumatology, Department of Internal Medicine, Gävle Hospital, 801 87 Gävle, Sweden;
  • Accepted 13 April 2005
  • Published Online First 20 April 2005


Background: Joint immobilisation improves the therapeutic effect of intra-articular glucocorticoid injection for knee synovitis. This may be due to retarded steroid resorption by immobilisation, a procedure that also could influence cartilage and bone metabolism.

Objective: To evaluate changes in cartilage and bone turnover after intra-articular glucocorticoid treatment for knee synovitis with and without postinjection rest.

Methods: 20 patients with rheumatoid arthritis and knee synovitis were randomised to 24 hour bed rest or to normal activity after intra-articular glucocorticoid treatment. Serum and urine markers of cartilage and bone turnover were studied for two weeks. Cartilage oligomeric matrix protein (COMP) was used as a marker of cartilage turnover, osteocalcin as marker of bone formation, and deoxipyridinoline (DPD) as marker of bone resorption.

Results: After the glucocorticoid injection COMP levels decreased in both groups (p<0.001), but significantly more in resting patients. Serum osteocalcin levels decreased significantly (p<0.001) without any difference between the groups. DPD was unchanged in both groups.

Conclusions: Intra-articular glucocorticoid treatment for knee synovitis reduced serum COMP, which suggests that such treatment may have a cartilage protective effect. The slightly larger decrease of serum COMP in the resting group may reflect a lower clearance of COMP from the joint cavity. Serum osteocalcin was temporarily reduced, indicating a reversible suppression of bone formation.


  • Published Online First 20 April 2005