[Intra-articular injections in arthrosis of the small and medium size joints]

Intraarticular injections into small and medium-size osteoarthritic joints may play an important role in the therapeutic plan. However, they are merely indicated if synovitis (with or without effusion) is present. Apart from irritating factors such as detritus or proteases, calcium pyrophosphate and hydroxyapatite are important pathogenetic factors in arthritis, i.e. activated osteoarthritis (2). The extent of the resulting pain and functional impairment in the mostly elderly patients often demands a rapid and efficient therapeutic action. An adequate indication provided, intraarticular administration of injectable corticosteroid preparations can afford quick relief. Although the progression of osteoarthritis will hardly be stopped, a persisting relief of pain can be achieved (13). Each intraarticular injection has to be considered a minor operation, so all its risks and possible complications have to be taken into account.