JOINT TEMPERATURE MEASUREMENT IN THE EVALUATION OF ANTI-ARTHRITIC AGENTS 12

Abstract

Serial joint temp. detn. is suggested as a rapid and possibly specific laboratory method for establishing additional evidence of therapeutic effectiveness of anti-arthritic agents. Serial intra-articular temp. detns. were made on 21 rheumatoid arthritic patients before, during, and after a course of parenteral-ly admd. ACTH or cortisone. The measurements were made using a filamentous Cu-constantan thermocouple inserted into the joint space through the bore of an aspirating needle and recorded in C by an automatic recording electronic potentiometer. Cell counts were made on the synovial fluid obtained at the time of the aspirations for temp. detn. in 9 of the 21 patients. In every instance there was a pronounced fall in joint temp. within the first 24 hours of ACTH or cortisone admn., which approached normal by the 4th day of the treatment period. Joint fluid cell counts also showed a pronounced drop. Cortisone was admd. orally to 6 patients with rheumatoid arthritis, with serial joint temp. detns. showing a similar fall in every instance. Eight patients with rheumatoid arthritis were given various other steroids for a period of one week, and serial joint temp. detns. made. The following steroids were studied: ;16-dehydro-pregnenolone acetate, 21-acetoxypregnenolone, testosterone propionate, delta-5 pregnenolone, 21-acetoxypregnenolone acetate. Without the patients'' knowledge cortisone was then substituted. None of these supposed anti-arthritic agents produced the fall in joint temp. which occurred in every case after substitution of cortisone.