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Knee Arthrocentesis in Adults

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Systemic effects of intra-articular corticosteroids.

George S Habib¹

¹Department of Medicine, Carmel Medical Center, Haifa, 34362, Israel. gshabib62@yahoo.com

Clinical Rheumatology

|March 3, 2009

Summary

This summary is machine-generated.

Intra-articular corticosteroid injections (IACIs) can affect the hypothalamic-pituitary-adrenal axis, causing temporary cortisol reduction. IACIs also impact blood glucose, inflammatory markers, and cytokines, potentially inducing remission in various arthritis types.

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Area of Science:

Rheumatology
Endocrinology
Pharmacology

Background:

Intra-articular corticosteroid injections (IACIs) are common treatments for joint inflammation.
Systemic effects beyond the joint are not fully understood.
A comprehensive review of published literature is needed.

Purpose of the Study:

To review all published English literature on the systemic effects of intra-articular corticosteroid injections (IACIs) in humans.
To identify and summarize objective findings outside the injected joint.

Main Methods:

Systematic literature search of Pubmed and reference lists up to 2007.
Inclusion of studies reporting objective findings outside the injected joint.
Focus on studies involving the hypothalamic-pituitary-adrenal axis, blood glucose, and inflammatory markers.

Main Results:

IACIs transiently suppress serum cortisol, with recovery taking 1-4 weeks.
Adrenocorticotropic hormone stimulation tests may show blunted responses post-IACI.
Blood glucose can transiently increase in diabetic patients; inflammatory markers and cytokines decrease.
Potential for remission in oligo-/polyarthritis and extra-articular manifestations.

Conclusions:

IACIs exert significant, albeit often transient, systemic effects.
Monitoring of endocrine and metabolic parameters may be warranted.
IACIs can modulate systemic inflammation and potentially induce disease remission.