Objective: To determine which intraarticular steroids are used by rheumatologists and whether this use and associated practice vary with time and place of training.
Method: American College of Rheumatology members were mailed questionnaires that focused on steroid use in the adult knee.
Results: The steroids favored by the respondents were methylprednisolone acetate (MPA), preferred most by those trained in the eastern U.S.; triamcinolone hexacetonide (TH), preferred by those trained in the Midwest and Southwest; and triamcinolone acetonide (TA), preferred by those trained in the West. Only TH was chosen primarily because of efficacy. Regardless of concentration, respondents used 1 ml of steroid. Most (especially those recently trained) combined steroid with local anesthetic. Post-injection instructions varied: 29% did not restrict weight-bearing; 8% recommended limited weight-bearing for 1 week or more.
Conclusion: MPA, TH, and TA were favored. Associated techniques varied, based in part on where and when training took place. Research is needed to provide a more rational basis for clinical practice.