Injectable corticosteroids in modern practice

J Am Acad Orthop Surg. Jan-Feb 2005;13(1):37-46. doi: 10.5435/00124635-200501000-00006.

Abstract

Long-lasting, crystalline suspensions of injectable corticosteroids have been used to treat joint and soft-tissue disorders for many years; they decrease inflammation by reducing local infiltration of inflammatory cells and mediators. Depot formulations differ in their characteristics. Compounds with low solubility are thought to have the longest duration of action but may cause tissue atrophy when used in soft tissues. Intra-articular corticosteroids are commonly used to treat osteoarthritis and inflammatory arthritis: meta-analyses confirm their benefit in reducing pain and symptoms. Intra-articular corticosteroid injections have been shown to be safe and effective for repeated use (every 3 months) for up to 2 years, with no joint space narrowing detected. Fewer clinical trials are available for extra-articular uses for injectable corticosteroids, although there is evidence of efficacy in a variety of soft-tissue conditions. The accuracy of injections affects outcomes. Postinjection flare, facial flushing, and skin and fat atrophy are the most common side effects. Systemic complications of injectable corticosteroids are rare.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Forecasting
  • Humans
  • Injections, Intra-Articular
  • Male
  • Musculoskeletal Diseases / diagnosis
  • Musculoskeletal Diseases / drug therapy
  • Orthopedics / standards
  • Orthopedics / trends
  • Pain Measurement
  • Prognosis
  • Range of Motion, Articular / drug effects*
  • Range of Motion, Articular / physiology
  • Recovery of Function
  • Rheumatic Diseases / diagnosis*
  • Rheumatic Diseases / drug therapy
  • Risk Assessment
  • Treatment Outcome
  • United States

Substances

  • Adrenal Cortex Hormones