Steroid arthropathy

Steroid arthropathy - This is a well known and much feared complication of local injection treatment- it is also largely a myth6 9 . There is evidence that in many instances injected steroids can be chondroprotective rather than destructive3 1 , 4 3 , but the information from animal models about whether steroids damage or protect joints is contradictory7 0 , 1 8 4 . There is good evidence linking prolonged highdose oral steroid usage with osteonecrosis, but almost all the reports linking injected steroids with accelerated non-septic joint destruction are anecdotal, and mainly relate to joints receiving huge numbers of injections6 9 . A reasonable
guide7 1 is to give injections into the major joints in the lower limbs at no less than 3-month intervals, although this advice is based on consensus rather than evidence7 2 1 8 5 . Reports of Charcot-like accelerated joint destruction after corticosteroid injection in human hip osteoarthritis (OA) might reflect the
disease itself rather than the treatment3 1 , 7 3 . Currently, no evidence supports the promotion of disease progression by steroid injections1 6 4 , 1 9 2 . Repeat injections into the knee joint every 3 months seem to be safe over 2 years1 6 5 .