Osteoarthritis intra-articular corticosteroids

There is no general case for using intra-articular corticosteroid in osteoarthritis but local injection of triamcinolone can provide relief for a single periarticular tender spot or for a knee joint that is acutely inflamed. 

Viscosupplementation via intra-articular hyaluronic acid injections is a conservative treatment modality to be used in conjunction with other conservative management modalities including activity modification, physical therapy, analgesics, nonsteroidal anti-inflammatories (NSAIDS), and intra-articular corticosteroid injections. It is only approved by the FDA for treating osteoarthritis of the knee. Off-label use has been reported for treatment of osteoarthritis affecting the earpometacarpal joints of the thumb, apophyseal joints of the lumbar spine, hip, ankle, and foot [1, 34, 40, 92, 101]. 

Drugs are applied to the mucous membranes of the conjunctiva, nasopharynx, and vagina to achieve local effects. On the other hand, the antidiuretic hormone lypressin (Diapid) is given by nasal spray, but the intention is to produce systemic effects. For the treatment of meningeal leukemia, cytosine arabinoside is injected directly into the spinal subarachnoid space. In osteoarthritis, corticosteroids are given by intra-articular injection. 

Qvistgaard E, Christensen R, Torp-Pedersen S, Bliddal H. Intra-articular treatment of hip osteoarthritis a randomized trial of hyaluronic acid, corticosteroid, and isotonic saline. Osteoarthritis Cartilage 2006 14 163-170. 

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See also in sourсe #XX -- [ , ]

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