Medical Hydrology and Balneology: Environmental Aspects

Effects of mud-bath applications on synovial
inflammation evaluated by contrasted-
enhanced ultrasound (CEUS) in patients with
psoriatic arthritis
Ciprian L (1) , Raffeiner B (1) , Grisan E (2) , Beltrame V (3) , Coran A (3) , Zanatta E (1) ,
Rizzo M (1) , Stramare R (3) , Cozzi F (1)
(1) Rheumatology Unit of Department of Medicine, Padova, Italy
(2) Department of Information Engineering, Padova, Italy
(3) Department of Medical Diagnostic Sciences and Special Therapies, Padova, Italy
luca.email@gmail.com
Introduction and Objectives
The effects of mud packs and thermal baths on inflammation are complex and
not yet fully understood. However, a recent basic research has shown favorable
results on animal models of chronic arthritis (Cozzi F., et al. Clin Exp Rheumatol
2004; 22:763-6).
The aim of the study was to evaluate the effects of thermal applications on synovial
inflammation in psoriatic arthrtitis (PA), using a new diagnostic method, the
contrast-enhanced ultrasound (CEUS), able to a precise detection and quantification
of finger joint vascularity (Stramare R, et al. J Clin Ultrasound 2012 Jan 30).
Materials and Methods
After obtaining permission from the local Ethics Committee, 32 patients with
PA (24 women and 8 men, mean age 53.2 years and mean disease duration of 11.8
years), in follow-up in the Rheumatology Unit of Padova University were enrolled.
All had peripheral joint involvement and were treated with TNF-inhibitors for at
least six months. Patients were randomized into two groups: 18 were submitted to a
cycle of mud-bath treatment maintaining pharmacological therapy (group A), 14
were treated with TNF-inhibitors alone (group B, controls). The mud-bath therapy
treatment was performed in a spa of the Euganean Area (Italy). Both groups were
evaluated at baseline (T0) and after 45 days (T1).
All patients were submitted to CEUS, in order to detect the finger joint vascularity.
The films obtained were evaluated by a blinded experienced Radiologist,
who used the three-point score (0 – 2) recommended by the IACUS study group
(Klauser A, et al. Eur Radiol 2005; 15:2404-10), and were processed with a dedicated
software, developed in collaboration with the Department of Information
Engineering of Padova University, able to determine a panel of vascularity parameters.
Statistical analysis was performed by Student t-test and Wilcoxon test.
Balnea
2012, núm. 6, 179-180
179
ISBN: 978-84-669-1887-0
978-84-669-3482-4