Cryotherapy and Doppler in Inflammatory Rheumatic Diseases


After informed consent, patients suffering from inflammatory rheumatic diseases (rheumatoid
arthritis, spondyloarthritis, crystal-induced arthritides) with non-septic arthritides were
randomized to receive either local ice (30 minutes twice a day) or cold gas (2 minutes twice
a day – pulsed hyperbaric CO2). Local cryotherapy was applied at 9 AM and 17 PM.

Skin temperature was monitored Knee power Doppler ultrasonography was performed before
cryotherapy (9 AM), just after, 2 min after, 2 hours after, before and after the second cold
application (8 hours after the first cold application), then the day after at 9 A.M (24 hours
after the first cold application).

Synovial fluid was also analysed after join arthrocentesis (just before the first cold
application, then 24 hours later, after the last ultrasonographic examination. A
corticosteroid injection was performed after the second arthrocentesis when necessary.

Power Doppler semi-quantitative scores (0-3) were then blindly assessed by a second trained
ultrasonographist at the different times of the study.

Pain VAS evolution was also monitored throughout the study. Clinical characteristics of
patients were collected at baseline. 20 patients suffering from ankle/wrist arthritides were
also included in order to evaluate power Doppler score evolution under cold gas or

15 patients suffering from knee arthritides were treated by local cold gas. 31 patients
suffering from knee arthritides were treated by ice. When both knees were arthritic,
contralateral synovial fluid and power Doppler score were used as non-treated controls.


Rheumatoid Arthritis



Start Date:

February 2013


Centre Hospitalier Universitaire de Besancon

For More Information: