A frequently performed treatment for osteoarthritis and other joint-related pain syndromes is intra-articular corticosteroid (IACS), yet there is conflicting evidence on the potential benefit and possible negative outcomes following such injections.
These findings appear online in the journal Radiology, according to the Boston University School of Medicine.
“As of today, there is no established recommendation or consensus regarding imaging, clinical, or laboratory markers before an IACS injection is performed to screen for osteoarthritis-related imaging abnormalities and repeating radiographs before each subsequent IACS injection to detect possible adverse joint findings remains controversial.”
— corresponding author Ali Guermazi, MD, PhD, chief of radiology at VA Boston Healthcare System and professor of radiology at Boston University School of Medicine (BUSM)
Guermazi and his colleagues had first reported that accelerated arthritis and joint destruction are observed in some patients who received intra-articular corticosteroid injections. (Radiology/2019)
Not Enough Evidence Exists for Conclusion
In this new study, Guermazi led an international expert panel of researchers who reviewed all published evidence in the literature and found not enough evidence exists to decisively draw a conclusion. However, they did recommend the use of imaging for first-time injections or multiple injections with the aim of mitigating the risk for joint collapse and total joint replacement.
In addition, the panel reviewed the current understanding of pain in osteoarthritis and summarized current international guidelines regarding indications for IACS injection. They also suggested profiles of those who would likely benefit most from IACS injection and recommended updating patient consent forms until further evidence on the topic is available.
The researchers hope that studies with mid- to long-term follow-up will soon be available and provide data from before and after IACS injection compared to appropriate controls.
“Understanding the real benefit of IACS in relieving joint pain is paramount,” Guermazi adds.
These findings appear online in the journal Radiology.
[Source(s): Boston University School of Medicine, EurekAlert]
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