- Steroid Menu:
- Relative Potency of Various Steroids:
- Triamcinolone: is the most common choice for joint injection (see knee osteoarthritis)
- 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 or use of "no touch technique";
- association between total knee infection and prior steroid injections;
- Infection in knee replacements after previous injection of intra-articular steroid.
- Effect of intra-articular steroids on deep infections following total knee arthroplasty.
- Does intraarticular steroid infiltration increase the rate of infection in subsequent total knee replacements?
- note that intra-articular steroids may interfere w/ lactation in nursing mothers; (see pregnancy considerations)
Intraarticular corticosteroids in treatment of osteoarthritis.
Injections in the treatment of osteoarthritis.
Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial.
Variation patterns of two degradation enzyme systems in articular cartilage in different stages of osteoarthritis: regulation by dehydroepiandrosterone.