[Rational intra-articular corticosteroid injection]

The intraarticular injection of corticosteroids has been a well known and effective therapy for rheumatoid arthritis and swollen joints of other, non-infectious origin for almost 50 years. Today the indication for this intervention has to be more restrictive, and possible alternative therapies must be discussed with the patient. The number of injections in weight-bearing joints should not exceed three per year, and should no effect be noted, there is no reason to repeat an intraarticular injection. As there is a considerable variability in the details of administration of the injection, and the legal implications are currently changing, the practical aspects are discussed in this article. An extensive review of the literature leads to the distinction of actual knowledge from adopted faith and points out the relevant measures to minimize the risks and increase the benefits of the injection; most important is a precise and quick "no-touch"-technique. The restrictive indication and a standardized practical procedure are the basis for successful intraarticular injection of corticosteroids.