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Wheeless' Textbook of Orthopaedics
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Articular Steroid Injections


- See:
      - Steroid Menu:
      - Relative Potency of Various Steroids:

- Triamcinolone: is the most common choice for joint injection;

- Cautions for Intra-Articular Injection:
    - local complications:
          - may cause fat necrosis and loss of skin pigmentation in blacks;
          - in some cases may accelerate joint degeneration;
    - system absorption may occur from intra-articular injection;
          - absorption is increased by usage of water soluble preparations, dose injected, and injection into multiple joints;
          - may cause transient hyperglycemia in diabetic patients (and therefore is contraindicated in type I or brittle diabetics);
          - avascular necrosis of the femoral head is a rare complication;
    - iatrogenic septic arthritis: (see septic arthritis)
          - uncommon problem but it does occur;
          - all joint injections should be performed using sterile technique, with a formal betadine prep and use of sterile gloves;
    - other
          - note that intra-articular steroids may interfere w/ lactation in nursing mothers; (see pregnancy considerations)






Intraarticular corticosteroids in treatment of osteoarthritis.

Intra-articular corticosteroid treatment in osteoarthritis.

Injections in the treatment of osteoarthritis.

Alterations of rabbit articular cartilage by intra-articular injections of glucocorticoids.

Effect of intra-articular corticosteroids on ligament properties: a biomechanical and histological study in rhesus knees.

Intrasynovial injection of steroids uses and abuses.

Effects of local injection of corticosteroids on the healing of ligaments. A follow-up report.

Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial.















Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Sunday, June 22, 2008 1:27 pm