Intrasynovial injection of steroids uses and abuses

Intra-articular injection of steroids is a valuable method of treatment, but selection of the appropriate clinical setting is required to obtain maximal benefits and to minimize the complications. All intra-articular injections must be performed under strict aseptic technique. The rheumatoid patient with one or two joints that resist systemic therapy and the patient with an occasional osteoarthritic joint with an acute inflammation are amenable to this treatment. The patient who has acute attacks of tendinitis, pseudogout, or bursitis will obtain significant benefits. Selected patients with traumatic and acute gouty arthritis also may benefit. Repetitive injections appear to be contra-indicated as they may create an environment conducive to joint destruction.