Steroid-induced hallucination following intra-articular administration: a case report and brief review

Amidst the ubiquitous use of steroids, psychiatric side-effects are not uncommon, though the presentation may be curiously diverse. The case of an elderly lady who had 40 mg of methylprednisolone injected in each knee for treatment of suprapatellar bursitis is presented. After 3 days, she reported visual hallucinations, which resolved without treatment 6 days after the steroid injections. We found considerable interest in this case as there were very few reported cases of adverse psychiatric events triggered by intra-articular steroid administration. We follow with a brief review of the incidence, risk factors, presentation, and treatment of steroid-induced psychiatric side-effects.