Intra-articular corticosteroid injections are indicated for which scenario, and what precautions apply?

• A. For OA or inflammatory arthritis with persistent pain; avoid septic joints; ensure no infection; counsel on risks
• B. For any joint pain, regardless of infection status
• C. As first-line treatment for acute fractures
• D. Only for septic joints

Answer: (A)

Intra-articular corticosteroid injections are used to relieve persistent pain and inflammation in joints affected by osteoarthritis or inflammatory arthritis when nonoperative measures haven’t fully controlled symptoms. The essential precaution is to confirm the joint is not septic; injecting into an infected joint can worsen infection and spread bacteria. Before the injection, assess for infection and use sterile technique. Patients should be counseled on potential risks, such as a brief post-injection flare, temporary elevation of blood glucose in diabetics, possible tissue or tendon effects with repeated injections, and a small risk of infection. This approach isn’t appropriate for all joint pain, isn’t first-line for acute fractures, and isn’t used when a joint is septic.