Sunday, January 8, 2017

Why not just give a cortisone shot?

Complications Associated with Intra-Articular and Extra-Articular Corticosteroid Injections

These authors review the complications associated with the common practice of cortisone injection.

They conclude:
*Side effects of corticosteroids can occur in association with both intra-articular and extra-articular injections.
*Less-severe reactions include skin reactions and flare responses.
*Although rare, worrisome complications such as infections, tendon ruptures, and osteonecrosis can occur.
*It is important to note the effect of corticosteroids on blood glucose levels, particularly for patients with diabetes.
*Corticosteroid injections have visual side effects with a known relation to central serous chorioretinopathy.

Comment: In our shoulder practice, cortisone injections are rarely used. The reasons are several: these steroids weaken connective tissues including tendons and articular cartilage, they increase the risk of periprosthetic infection, and they do not treat the common shoulder pathologies of cuff or degenerative joint disease.


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