Local effects of intra-articular corticosteroids.

Area of Science:

• Rheumatology
• Orthopedics
• Pharmacology

Background:

• Intra-articular corticosteroid injections (IACIs) are frequently utilized for joint pain management.
• Understanding the localized effects of IACIs is crucial for optimizing treatment and patient outcomes.

Purpose of the Study:

• To comprehensively review the published literature on the local effects of intra-articular corticosteroid injections.
• To document both beneficial and adverse local effects across various joint conditions.

Main Methods:

• Systematic English literature search on PubMed using terms 'intra-articular' and 'local effect'.
• Inclusion of studies examining subjective, functional, structural, cellular, humoral, molecular, and imaging aspects.
• Documentation of all reported local adverse effects.

Main Results:

• The primary benefit of IACI is pain relief, with variable duration dependent on disease type and severity.
• Favorable responses are more pronounced in inflammatory conditions, such as juvenile idiopathic arthritis, with longer remission periods.
• No significant joint structural damage (e.g., joint space loss, cartilage erosion) was observed following multiple or single IACIs in osteoarthritis and rheumatoid arthritis, respectively.

Conclusions:

• Intra-articular corticosteroid injections demonstrate a wide spectrum of local effects, with prominent subjective and functional improvements in inflammatory arthritis.
• While generally safe, potential local adverse effects like calcifications and atrophy can occur but are infrequent.
• Image-guided IACIs may enhance treatment efficacy in specific joints.