CORTICOSTEROIDS FOR TREATMENT OF RHEUMATOID ARTHRITIS (RA): CORTICOSTEROID INJECTIONS

In RA it is common for one joint to become more swollen than others or to lag behind the others in improvement. An injection of corticosteroids directly into the joint will decrease the pain, warmth, and swelling in the joint that is giving the person the most trouble. The beneficial effects generally last four to six weeks.

This is a frequently performed and effective procedure that is generally safe and well tolerated. Before the injection is administered, the skin is generally numbed with a local anesthetic. (Be certain to warn your doctor if you have ever had a reaction to local anesthetics such as Novocain or Xylocaine.) A needle is then introduced through the skin and into the joint, into which the corticosteroid is injected.

The side effects of the small amount of corticosteroid injected into the joint are minimal. If a given joint is injected no more frequently than every four months, adverse effects from the corticosteroid itself are unlikely.

Corticosteroid injection into the same joint more frequently than every four months, however, may cause joint damage. In fewer than 5 percent of patients the injected corticosteroid can actually increase inflammation for a short period. This is known as a post-infection flare. Although uncomfortable, the inflammation will decrease within two to three days. It is impossible to tell in advance of the injection whether a particular individual will suffer this side effect.

Occasionally, a dimple in the skin or a mild change in skin color will be noticed at the site of injection. These skin changes will almost always disappear with time.

As with any procedure, complications related to the procedure itself can arise. Care must be taken to avoid injuring surrounding tendons or other structures. Sterile technique is required to prevent the possibility of introducing bacteria and infection into the joint. Experienced physicians, generally rheumatologists or orthopedic surgeons, take exceptional care to avoid these complications.

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CORTICOSTEROIDS FOR TREATMENT OF RHEUMATOID ARTHRITIS (RA): CORTICOSTEROID INJECTIONSIn RA it is common for one joint to become more swollen than others or to lag behind the others in improvement. An injection of corticosteroids directly into the joint will decrease the pain, warmth, and swelling in the joint that is giving the person the most trouble. The beneficial effects generally last four to six weeks.This is a frequently performed and effective procedure that is generally safe and well tolerated. Before the injection is administered, the skin is generally numbed with a local anesthetic. (Be certain to warn your doctor if you have ever had a reaction to local anesthetics such as Novocain or Xylocaine.) A needle is then introduced through the skin and into the joint, into which the corticosteroid is injected.The side effects of the small amount of corticosteroid injected into the joint are minimal. If a given joint is injected no more frequently than every four months, adverse effects from the corticosteroid itself are unlikely.Corticosteroid injection into the same joint more frequently than every four months, however, may cause joint damage. In fewer than 5 percent of patients the injected corticosteroid can actually increase inflammation for a short period. This is known as a post-infection flare. Although uncomfortable, the inflammation will decrease within two to three days. It is impossible to tell in advance of the injection whether a particular individual will suffer this side effect.Occasionally, a dimple in the skin or a mild change in skin color will be noticed at the site of injection. These skin changes will almost always disappear with time.As with any procedure, complications related to the procedure itself can arise. Care must be taken to avoid injuring surrounding tendons or other structures. Sterile technique is required to prevent the possibility of introducing bacteria and infection into the joint. Experienced physicians, generally rheumatologists or orthopedic surgeons, take exceptional care to avoid these complications.*106/209/5*

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