Advertisement

Overview of Injectable Corticosteroids

Published:April 30, 2012DOI:https://doi.org/10.1016/j.jhsa.2012.03.010
      Injectable corticosteroids remain an important intervention in the management of multiple hand and upper extremity conditions. Common uses include intra-articular applications, with the goal of symptomatic relief in osteoarthritis, rheumatoid arthritis, and crystal deposition diseases, as well as extra-articular injections for tendinopathies and nerve compression syndromes. There is little high-quality evidence to guide which steroid to use in a given clinical situation; however, an understanding of the mechanisms of action, pharmacologic profiles, and associated complications of different steroid preparations can help guide the clinician in appropriate corticosteroid selection.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Barnes P.J.
        Anti-inflammatory actions of glucocorticoids: molecular mechanisms.
        Clin Sci (Lond). 1998; 94: 557-572
        • D'Acquisto F.
        • Paschalidis N.
        • Raza K.
        • Buckley C.D.
        • Flower R.J.
        • Perretti M.
        Glucocorticoid treatment inhibits annexin-1 expression in rheumatoid arthritis CD4+ T cells.
        Rheumatology (Oxford). 2008; 47: 636-639
        • Caldwell J.R.
        Intra-articular corticosteroids.
        Drugs. 1996; 52: 507-514
        • Lavelle W.
        • Levelle E.D.
        • Lavelle L.
        Intra-articular injection.
        Med Clin North Am. 2007; 91: 241-250
        • Derendorf H.
        • Mollmann H.
        • Gruner A.
        • Haack D.
        • Gyselby G.
        Pharmacokinetics and pharmacodynamics of glucocorticoid suspensions after intra-articular administration.
        Clin Pharmacol Ther. 1986; 39: 313-317
        • Centero L.M.
        • Moore M.E.
        Preferred intra-articular corticosteroids and associated practice: A survey of members of the American College of Rheumatology.
        Arthritis Care Res. 1994; 7: 151-155
        • Hochberg M.C.
        • Perlnutter D.L.
        • Hudson J.I.
        • Altman R.D.
        Preferences in the management of osteoarthritis of the hip and knee: results of a survey of community-based rheumatologists in the United States.
        Arthritis Care Res. 1996; 9: 170-176
        • Blankenbaker D.G.
        • De Smet A.A.
        • Stanczak J.D.
        • Fine J.P.
        Lumbar radiculopathy: treatment with selective lumbar nerve blocks—comparison of effectiveness of triamcinolone and betamethasone injectable suspensions.
        Radiology. 2005; 237: 738-741
        • Charalambous C.P.
        • Tryfonidis M.
        • Sadiq S.
        • Hirst P.
        • Paul A.
        Septic arthritis following intra-articular steroid injection of the knee: A survey of current practice regarding antiseptic technique used during intra-articular steroid injection of the knee.
        Clin Rheumatol. 2003; 22: 386-390
        • Berger R.G.
        • Yount W.J.
        Immediate “steroid flare” from intraarticular triamcinolone hexacetonide injection: case report and review of the literature.
        Arthritis Rheum. 1990; 33: 1284-1286
        • Kumar N.
        • Newman R.J.
        Complications of intra- and peri-articular steroid injections.
        Br J Gen Pract. 1999; 49: 465-466
        • Cassidy J.T.
        • Bole G.G.
        Cutaneous atrophy secondary to intra-articular corticosteroid administration.
        Ann Intern Med. 1966; 65: 1008-1018
        • Lund I.M.
        • Donde R.
        • Knudsen E.A.
        Persistent local cutaneous atrophy following corticosteroid injection for tendinitis.
        Rheumatol Rehabil. 1979; 18: 91-93
        • Shumaker P.R.
        • Rao J.
        • Goldman M.P.
        Treatment of local, persistent cutaneous atrophy following corticosteroid injection with normal saline infiltration.
        Dermatol Surg. 2005; 31: 1340-1343
        • Acevedo J.I.
        • Beskin J.L.
        Complications of plantar fascia rupture associated with corticosteroid injection.
        Foot Ankle Int. 1998; 19: 91-97
        • Wong M.W.
        • Tang Y.N.
        • Fu S.C.
        • Lee K.M.
        • Chan K.M.
        Triamcinolone suppresses human tenocyte cellular activity and collagen synthesis.
        Clin Orthop Relat Res. 2004; 421: 277-281
        • Habib G.S.
        • Abu-Ahmad R.
        Lack of effect of corticosteroid injection at the shoulder joint on blood glucose levels in diabetic patients.
        Clin Rheumatol. 2007; 26: 566-568
        • Wang A.A.
        • Hutchinson D.T.
        The effect of corticosteroid injection for trigger finger on blood glucose level in diabetic patients.
        J Hand Surg. 2006; 31A: 979-981
        • Baumgarten K.M.
        • Gerlach D.
        • Boyer M.I.
        Corticosteroid injection in diabetic patients with trigger finger: a prospective, randomized, controlled double-blinded study.
        J Bone Joint Surg. 2007; 89A: 2604-2611
        • Behrens F.
        • Shepard N.
        • Mitchell N.
        Alterations of rabbit articular cartilage by intra-articular injections of glucocorticoids.
        J Bone Joint Surg. 1975; 57A: 70-76
        • Raynauld J.P.
        • Buckland-Wright C.
        • Ward R.
        • Choquette D.
        • Haraoui B.
        • Martel-Pelletier J.
        • et al.
        Safety and efficacy of long-term intra-articular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial.
        Arthritis Rheum. 2003; 48: 370-377
        • Benzon H.T.
        • Chew T.L.
        • McCarthy R.J.
        • Benzon H.A.
        • Walega D.R.
        Comparison of the particle sizes of different steroids and the effect of dilution: a review of the relative neurotoxicities of the steroids.
        Anesthesiology. 2007; 106: 331-338
        • Brinks A.
        • Koes B.W.
        • Volkers A.C.
        • Verhaar J.A.
        • Bierma-Zeinstra S.M.
        Adverse effects of extra-articular corticosteroid injections: a systematic review.
        BMC Musculoskelet Disord. 2010; 11: 206
        • Rozental T.D.
        • Sculco T.P.
        Intra-articular corticosteroids: an updated overview.
        Am J Orthop. 2000; 29: 18-23
        • Snibbe J.C.
        • Gambardella R.A.
        Use of injections for osteoarthritis in joints and sports activity.
        Clin Sports Med. 2005; 24: 83-91
        • Lindenhovius A.
        • Marjolijn H.
        • Gilligan B.P.
        • Lozano-Calderon S.
        • Jupiter J.B.
        • Ring D.
        Injection of dexamethasone versus placebo for lateral elbow pain: a prospective, double-blind, randomized clinical trial.
        J Hand Surg. 2008; 33A: 909-919
        • Wolf J.M.
        • Ozer K.
        • Scott F.
        • Gordon M.J.V.
        • Williams A.E.
        Comparison of Autologous blood, corticosteroid, and saline injection in the treatment of lateral epicondylitis: a prospective, randomized, controlled multicenter study.
        J Hand Surg. 2001; 36A: 1269-1272