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Intra-articular glucocorticoid injections and their effect on hypothalamic-pituitary-adrenal (HPA)-axis function.
[cushing syndrome]
The
use
of
intra-articular
(
IA
)
glucocorticoids
for
reducing
pain
and
inflammation
in
patients
with
osteoarthritis
,
rheumatoid
arthritis
,
and
other
inflammatory
arthropathies
is
widespread
among
primary
care
physicians
,
specialists
,
and
non-specialists
in
the
United
States
.
Injectable
glucocorticoids
have
anti-
inflammatory
and
analgesic
properties
which
can
be
effective
in
improving
clinical
parameters
such
as
pain
,
range
of
motion
,
and
quality
of
life
.
After
injection
into
the
IA
space
,
glucocorticoids
may
be
systemically
absorbed
;
the
degree
of
absorption
can
depend
on
the
size
of
the
joint
injected
,
the
injectable
glucocorticoid
preparation
used
,
the
dosage
,
and
the
frequency
of
the
injection
.
The
adverse
effects
of
intra-articular
glucocorticoid
injections
(
IAGC
)
can
often
be
overlooked
by
both
the
patient
and
physicians
who
administer
them
,
in
particular
the
potential
deleterious
effect
on
the
hypothalamic
-
pituitary
-
adrenal
(
HPA
)
-
axis
which
can
result
in
adrenal
suppression
and
/
or
iatrogenic
Cushing
syndrome
.
In
this
paper
we
provide
an
overview
on
the
often
under-recognized
effects
of
IAGC
on
HPA-axis
function
.
Diseases
Validation
Diseases presenting
"potential deleterious effect"
symptom
cushing syndrome
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