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Corticosteroid Intra-articular Injections

Arthritis is characterized by pain and swelling of the joints. It is an autoimmune disease in which body’s own immune system attacks the healthy cartilage of the joints leading to inflammation of the joints. Steroids possess anti-inflammatory activity. Thus are used for the treatment of arthritis. Oral administration of steroids is effective in treatment of arthritis but also causes side effects on other organ system. Side effects of oral steroid therapy include muscle weakness, diabetes, slow healing of wounds, thinning of skin, stomach ulcers, weight gain, high blood pressure and mood swings. Thus intra-articular injection with corticosteroid is preferred over oral therapy. Corticosteroid intra-articular injections are useful in treating knee arthritis associated with synovitis and effusion.

 In intra-articular therapy the steroid is given directly into the affected joint. Thus more dose can be given and the effect is more localized. Sometimes infection at the injected site may occur. Thus extreme precautions are taken to maintain sterile procedures while giving the injection. Repeated intra-articular injection in a joint leads to cartilage damage. So injection in a particular joint are repeated only after few months of gap. Sometimes local anesthetics are also given with corticosteroids to improve pain management with a low dose of corticosteroid.

Image guidance tools such as ultrasound, fluoroscopy and radiopaque tracer are now being increasingly used to facilitate intra-articular injection in difficult to reach joints such as hip and shoulder joints. After intra-articular injection you should give rest to the joint for few days as reduced activity delays the absorption of the steroid from the joint and prevents its systemic effect.

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