[Is osteoarthritis an inflammatory disease after all?; prednisolone effective in osteoarthritis of the hand].

There are very few treatment options that modify the course of osteoarthritis (OA) of the hand; the only current treatment options are physiotherapy and analgesics. At the moment, OA is regarded as a disease of the entire joint, with involvement of cartilage, bone, synovium, ligaments and muscles and new treatment options can focus on these structures. In a double-blind, placebo-controlled trial, treatment of patients with inflammatory OA of the hand (with pain, soft-tissue swelling and an ultrasound picture characteristic of inflammation) with 10 mg prednisolone per day for 6 weeks resulted in a larger decrease in pain than placebo did. This short-term study does certainly not provide the definitive answer for treating this chronic disease, and long-term use of prednisolone is associated with several side-effects. Nevertheless, this breakthrough study clearly demonstrates that the use of anti-inflammatory, anti-rheumatic medication may have a favourable effect on inflammatory OA of the hand. Studies of anti-inflammatory drugs with a better long-term safety profile will be welcome.