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Local injection therapy

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Management of Rheumatic Disorders

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Abstract

Soon after the introduction of systemic corticosteroids Thorn (cited by Hollander, 1972) injected 10 mg hydrocortisone into a knee joint affected by rheumatoid arthritis with local and systemic benefit. However, the procedure did not become established until some years later when Hollander and colleagues (1951a, b) reported their findings from the University of Pennsylvania. These early findings, which demonstrated the efficacy of intra-articular injections, were further substantiated by a report a decade later (Hollander et al., 1961) based on the injection of joints, bursae and tendon sheaths in a series of 4000 patients.

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References And Further Reading

General aspects of injection therapy

  • Ansell, B.M. (1980) in Rheumatic Disorders in Childhood, Butterworths, London, p. 143.

    Google Scholar 

  • Baker, W.M. (1877) The formation of abnormal synovial cysts in connection with the joints. St. Bartholomew’s Hosp. Rep., 13, 245.

    Google Scholar 

  • Balch, H.W. and Jacomb, R.G. (1967) Parenteral administration of 6 a-methylprednisolone-21-acetate. Part I. Intraarticular injection: comparison with hydrocortisone acetate. Ann. Phys. Med., 9, 43.

    PubMed  Google Scholar 

  • Behrens, F., Shephard, N. and Mitchell, N. (1975) Alteration of rabbit articular cartilage by intra-articular injections of glucocorticoids. J. Bone Joint Surg., 57A, 70.

    PubMed  CAS  Google Scholar 

  • Bird, H.A. and Ring, E.F.J. (1978) Therapeutic value of arthroscopy. Ann. Rheum. Dis., 37, 78.

    Article  PubMed  CAS  Google Scholar 

  • Boyle, A.C. (1977) in Copeman’s Textbook of Rheumatic Diseases, (ed. J.T. Scott), 5th edn, Churchill Livingstone, Edinburgh, p. 1032.

    Google Scholar 

  • Cohen, S.H. (1977) in Rheumatic Diseases — Diagnosis and Management, (ed. W.A. Katz), Lippincott, Philadelphia, p. 910.

    Google Scholar 

  • Collins, A.J. and Cosh, J.A. (1970) Temperature and biochemical studies of joint inflammation. Ann. Rheum. Dis., 29, 386.

    Article  PubMed  CAS  Google Scholar 

  • Corbett, M., Seifert, M.H., Hacking, C and Webb, S. (1970) Comparison between local injections of silicone oil and hydrocortisone acetate in chronic arthritis. Br. Med. J., i, 24.

    Article  Google Scholar 

  • Cyriax, J. and Russell, G. (1977) Textbook of Orthopaedic Medicine. Treatment by Manipulation, Massage and Injection, Volume 2. Baillière Tindall, London, pp. 234 and 328.

    Google Scholar 

  • Haslock, I. (1976) in Clinics in the Rheumatic Diseases (ed. V. Wright), Vol. 2, No. 3, Saunders, London, p. 621.

    Google Scholar 

  • Hollander, J.L. (1951a) The local effects of compound F (hydrocortisone) injected into joints. Bull. Rheum. Dis., 2, 3.

    PubMed  CAS  Google Scholar 

  • Hollander, J.L., Brown, E.J., Jessar, R.A. and Brown, C.V. (1951b) Hydrocortisone and cortisone injected into arthritic joints. J. Am. Med. Assoc, 147, 1629.

    Article  PubMed  CAS  Google Scholar 

  • Hollander, J.L., Brown, E.M., Jessar, R.A. et al. (1954) Local anti-rheumatic effectiveness of higher esters and analogues of hydrocortisone. Ann. Rheum. Dis., 13, 297.

    Article  PubMed  CAS  Google Scholar 

  • Hollander, J.L., Jessar, R.A. and Brown, E.M. (1961) Intrasynovial corticosteroid therapy: a decade of use. Bull. Rheum. Dis., 11, 239.

    PubMed  CAS  Google Scholar 

  • Hollander, J.L., Jessar, R.A., Restifo, R.A. and Fort, H.J. (1961) A new intra-articular steroid ester with longer effectiveness. Arthr. Rheum., 4, 422 (Abstract).

    Google Scholar 

  • Huskisson, E.C. and Hart, F. (1975) Joint Disease: All the Arthropathies, 2nd edn, Wright, Bristol, p. x.

    Google Scholar 

  • Jayson, M.I.V. and Dixon, A. St. J. (1968) Arthroscopy of the knee in rheumatic diseases. Ann. Rheum. Dis., 27, 503.

    Article  PubMed  CAS  Google Scholar 

  • Jayson, M.I.V. and Dixon, A. St. J. (1970) Valvular mechanisms in juxta-articular cysts. Ann. Rheum. Dis., 29, 415.

    Article  PubMed  CAS  Google Scholar 

  • Lewis, D.A. and Day, E.H. (1972) Biochemical factors in the action of steroids on diseased joints in rheumatoid arthritis. Ann. Rheum. Dis., 31, 374.

    Article  PubMed  CAS  Google Scholar 

  • Lindsay, D.J., Ring, E.F.J., Coorey, P.F.J. and Jayson, M.I.V. (1971) Synovial irrigation in rheumatoid arthritis. Acta Rheumatol. Scand., 17, 169.

    PubMed  CAS  Google Scholar 

  • McCarty, D.J. (1968) A basic guide to arthrocentesis. Hosp. Med., 4, 77.

    Google Scholar 

  • McCarty, D.J. (1972) Treatment of rheumatoid joint inflammation with triamcinolone hexacetonide. Arthr. Rheum., 15, 157.

    Article  CAS  Google Scholar 

  • Menkes, C.J., Aignan, M., Galmiche, B. and Le Go, A. (1972) Le traitment des rhumatismes par les synoviorthèses. Choix des malades, choix des articulations, modalités pratiques, résultats indications, contra-indications. Rhumatologie, 2 (Suppl. to No. 1), 61.

    Google Scholar 

  • Miller, J.A. (1957) Joint paracentesis from an anatomic point of view. II. Hip, knee, ankle and foot. Surgery, 41, 999.

    PubMed  Google Scholar 

  • Murray, R.O. (1961) Steroids and the skeleton. Radiology, 77, 729.

    PubMed  CAS  Google Scholar 

  • Osler, W. (1910) The Principles and Practice of Medicine, 7th edn. Appleton, New York.

    Google Scholar 

  • Steinbrocker, O. (1939) Local injections and regional analgesia with procaine solutions for intractable pain in chronic arthritis and related conditions. Ann. Int. Med., 12, 1917.

    Article  Google Scholar 

  • Taylor, A.R. and Rana, N.A. (1973) A valve. An explanation of the formation of popliteal cysts. Ann. Rheum. Dis., 32, 419.

    Article  PubMed  CAS  Google Scholar 

  • Ziff, M., Contreres, V. and Schmid, T.R. (1956) Use of the hypospray jet injector for the intra-articular and local administration of hydrocortisone acetate. Ann. Rheum. Dis., 15, 227.

    Article  PubMed  Google Scholar 

Local injection of non-steroidal drugs

  • Ansell, B.M., Crook, A., Mallard, J.R. and Bywaters, E.G.L. (1963) Evaluation of intra-articular colloidal gold 198Au in the treatment of persistent knee effusions. Ann. Rheum. Dis., 22, 435.

    Article  PubMed  CAS  Google Scholar 

  • Anttinen, J. and Oka, M. (1975) Intra-articular triamcinolone hexacetonide and osmic acid in persistent synovitis of the knee. Scand. J. Rheumatol., 4, 125.

    Article  PubMed  CAS  Google Scholar 

  • Bayly, R.J., Peacegood, J.A. and Peake, S.C. (1973) Yttrium 90 ferric hydrochloric colloid. Ann. Rheum. Dis., 32 (Suppl.), 10.

    Article  PubMed  Google Scholar 

  • Beer, T.C., Crawley, J.C.W., Farran, H.E.A. and Gumpel, J.M. (1973) Preliminary assessment of 90Y ferric hydrochloride colloid. Ann. Rheum. Dis., 32 (Suppl.), 41.

    Article  PubMed  Google Scholar 

  • Berglöf, F.E. (1959) Osmic acid in arthritis therapy. Acta Rheumatol. Scand., 5, 70.

    Article  PubMed  Google Scholar 

  • Bridgman, J.F., Bruckner, F. and Bleehan, N.M. (1971) Radioactive yttrium in the treatment of rheumatoid knee effusions. Ann. Rheum. Dis., 30, 180.

    Article  PubMed  CAS  Google Scholar 

  • Cohen, Y. (1970) in Analytical Control of Radiopharmaceuticals, International Atomic Energy Agency, Vienna, p. 1.

    Google Scholar 

  • Collan, Y., Servo, C. and Winblad, I. (1971) An acute immune response to intra-articular injection of osmium tetroxide. Acta Rheumatol. Scand., 17, 236.

    PubMed  CAS  Google Scholar 

  • Currey, H.L.F. (1965) Intra-articular thiotepa in rheumatoid arthritis. Ann. Rheum. Dis., 24, 382.

    Article  PubMed  CAS  Google Scholar 

  • Flatt, A.E. (1962) Intra-articular thio-tepa in rheumatoid disease of the hands. Rheumatism, 18, 70.

    PubMed  CAS  Google Scholar 

  • Gumpel, J.M. (ed.) (1973) Symposium on radioactive colloids in the treatment of rheumatoid arthritis. Ann. Rheum. Dis., 32 (Suppl.).

    Google Scholar 

  • Gumpel, J.M. (1974) The role of radiocolloids in the treatment of arthritis. Rheumatol. Rehabil, 13, 1.

    Article  PubMed  CAS  Google Scholar 

  • Gumpel, J.M. and Stevenson, A.C. (1975) Chromosomal damage after intra-articular injection of different colloids of yttrium 90. Rheumatol. Rehabil., 14, 7.

    Article  PubMed  CAS  Google Scholar 

  • Gumpel, J.M., Williams, E.D. and Glass, H.I. (1972) Radio- dosimetry of 90yttrium and its distribution through the body, following injection into the knee. Rhumatologie, 2 (Suppl. to No. 1), 45.

    Google Scholar 

  • Henderson, E.O. and Nathan, F.F. (1969) Experience with injection of nitrogen mustard into joints of patients with rheumatoid arthritis. S. Med. J., 62, 1455.

    Article  CAS  Google Scholar 

  • Hurri, L., Sievers, K. and Oka, M. (1963) Intra-articular osmic acid in rheumatoid arthritis. Acta Rheumatol. Scand., 9, 20.

    Article  PubMed  CAS  Google Scholar 

  • Ingrand, J. (1973) Characteristics of radio-isotopes for intraarticular therapy. Ann. Rheum. Dis., 32 (Suppl.), 3.

    Article  PubMed  Google Scholar 

  • Loevinger, R., Japha, E.M. and Brownell, G.L. (1965) in Discrete radioisotope sources in ‘Radiation Dosimetry’ (eds G.H. Hine and G.L. Brownell). Academic Press, New York, p. 693.

    Google Scholar 

  • Makin, M. and Robin, G.C. (1964) Chronic synovial effusion treated with intra-articular radioactive gold. J. Am. Med. Assoc., 188, 725.

    Article  CAS  Google Scholar 

  • Martio, J., Isomaki, H., Heikkola, T. and Laine, V. (1972) The effect of intra-articular osmic acid in juvenile rheumatoid arthritis. Scand. J. Rheumatol., 1, 5.

    Article  PubMed  CAS  Google Scholar 

  • Muller, J.-H. (1962) Radioactive Isotope Therapy with Particular Reference to the Use of Colloids. AIEA Review, Series No. 27. International Atomic Energy Agency, Vienna.

    Google Scholar 

  • Neustadt, D.H. and Steinbrocker, O. (1956) Observations on the effects of intra-articular phenylbutazone. J. Lab. Clin. Med., 47, 284.

    PubMed  CAS  Google Scholar 

  • Oka, M., Rekonen, A., Ruotsi, A. and Seppata, O. (1971) Intra-articular injection of Y-90 resin colloid in the treatment of rheumatoid knee joint effusions. Acta Rheumatol. Scand., 17, 148.

    PubMed  CAS  Google Scholar 

  • Rekonen, A., Oka, M. and Ruotsi, A. (1972) Intra-articularly injected 90Y resin colloid. Distribution, fate, and dosimetry. Rheumatologie, 2 (Suppl. to No. 1), 53.

    Google Scholar 

  • Scherbel, A.L., Schuchter, S.L. and Weyman, S.J. (1957) II. Intra-articular administration of nitrogen mustard alone and combined with a corticosteroid for rheumatoid arthritis. Cleveland Clin. Q., 24, 78.

    Article  CAS  Google Scholar 

  • Vasilionkaitis, V. and Matulis, A. (1977) Trials on the prevention and treatment of osteoarthritis by intra-articular use of artificial lubricants. Proceedings of the 14th International Congress of Rheumatology, 1977, Abstract 449, p. 113.

    Google Scholar 

  • Wenley, W.G. and Glick, E.N. (1964) Medical synovectomy with thiotepa, Ann. Phys. Med., 7, 287.

    Google Scholar 

  • Wright, V., Haslock, I., Dowson, E. et al. (1971) Evaluation of silicone as an artificial lubricant in osteoarthrotic joints. Br. Med. J., ii, 370.

    Article  Google Scholar 

Deleterious effects of local corticostoroid therapy

  • Bentley, G. and Goodfellow, J.W. (1969) Disorganization of the knees following intra-articular hydrocortisone injections. J. Bone Joint Surg., 51B, 498.

    CAS  Google Scholar 

  • Boksenbaum, M. and Mendelson, C.G. (1963) Aseptic necrosis of the femoral head associated with steroid arthropathy. J. Am. Med. Assoc, 184, 262.

    Article  CAS  Google Scholar 

  • Chandler, G.N. and Wright, V. (1958) Deleterious effects of intra-articular hydrocortisone. Lancet, ii, 661.

    Article  Google Scholar 

  • Chandler, G.N., Jones, D.T., Wright, V. and Hartfall, S.J. (1959) Charcot’s arthropathy following intra-articular hydrocortisone. Br. Med. J., i, 952.

    Article  Google Scholar 

  • Ismail, A.M., Balakroknan, R. and Rajakumar, M.H. (1969) Rupture of patellar ligament after steroid infiltration. J. Bone Joint Surg., 51B, 4033.

    Google Scholar 

  • Hartnagel, E.E. (1962) Prolonged steroid therapy and accelerated joint destruction. Am. Pract., 13, 480.

    Google Scholar 

  • Heimann, W.G. and Freiberger, R.H. (1960) Avascular necrosis of the femoral and humeral heads after high-dosage corticosteroid therapy. N. Engl. J. Med., 263, 672.

    Article  PubMed  CAS  Google Scholar 

  • Lee, H.B. (1957) Avulsion and rupture of tendocalcaneous after injection of hydrocortisone. Br. Med. J., ii, 395.

    Article  Google Scholar 

  • McCarty, D.J. and Hogan, J.M. (1964) Inflammatory reaction after intrasynovial injection of microcrystalline adrenocorticosteroid esters. Arthr. Rheum., 7, 359.

    Article  Google Scholar 

  • Miller, W.T. and Restifo, R.A. (1966) Steroid arthropathy. Radiology, 86, 652.

    PubMed  CAS  Google Scholar 

  • Steinberg, C.L., Duthie, R.B. and Piva, A.E. (1962) Charcot-like arthropathy following intra-articular hydrocortisone. J. Am. Med. Assoc., 181, 851.

    Article  CAS  Google Scholar 

  • Sweetman, R. (1969) Corticosteroid arthropathy and tendon rupture. J. Bone Joint Surg., 51B, 397.

    Google Scholar 

  • Sweetman, D.R., Mason, R.M. and Murray, R.O. (1960) Steroid arthropathy of the hip. Br. Med. J., i, 1392.

    Google Scholar 

Methodology

  • Baum, J. and Ziff, M. (1967) Use of the hypospray jet injector for intra-articular injection. Ann. Rheum. Dis., 26, 143.

    Article  PubMed  CAS  Google Scholar 

  • Bocanegra, T.S., McClelland, J.J., Germain, B.F. and Espinoza, L.R. (1980) Intraarticular fragmentation of a new Parker — Pearson synovial biopsy needle. J. Rheumatol., 7, 248.

    PubMed  CAS  Google Scholar 

  • Dixon, A. St. J. and Graber, J. (1978–80) Local Injection Therapy (LIT) in Rheumatic Diseases (Education Separatum), EULAR Bulletin, Parts 1–12, Vols 7–9.

    Google Scholar 

  • Gottlieb, N.L. (1981) Hypodermic needle separation during arthrocentesis. Arthr. Rheum., 24, 1593.

    Article  CAS  Google Scholar 

  • Guzman, L. and Arinoviche, R. (1978) Intraarticular fracture of synovial biopsy needle. Arthr. Rheum., 21, 742.

    Article  CAS  Google Scholar 

  • Hollander, J.L. (1979) in Arthritis and Allied Conditions: A Textbook of Rheumatology, (ed. D.J. McCarty), 9th edn, Lea and Febiger, Philadelphia, pp. 402.

    Google Scholar 

  • Huskisson, E.C. and Hart, F.D. (1975) Joint Diseases: All the Arthropathies. Wright, Bristol, p. X.

    Google Scholar 

  • McCarty, D.J. (1979) in Arthritis and Allied Conditions; A Textbook of Rheumatology (ed. D.J. McCarty), 9th edn, Lea and Febiger, Philadelphia, p. 51.

    Google Scholar 

  • Owen, D.S. (1981) in Textbook of Rheumatology, (eds W.N. Kelley, E.D. Harris, S. Ruddy and C.B. Sledge), Saunders, Philadelphia, p. 553.

    Google Scholar 

  • Rankin, T.J. and Good, A.E. (1966) Corticosteroid injection of small joints by hypospray. Arthr. Rheum., 9, 611.

    Article  Google Scholar 

  • Ropes, M.W. and Bauer, W. (1953) Synovial Fluid Changes in Joint Disease. Harvard University Press, Cambridge, Massachusetts.

    Google Scholar 

  • Steinbrocker, O. and Neustadt, D.H. (1972) Aspiration and Injection Therapy in Arthritis and Musculoskeletal Disorders, Harper and Row, Hagestown.

    Google Scholar 

Local corticosteroid therapy of specific sites

  • Brown, B.B. (1978) Diagnosis and therapy of common myofascial syndromes. J. Am. Med. Assoc, 239, 646.

    Article  Google Scholar 

  • Clarke, A.K. and Woodland, J. (1975) Comparison of two steroid preparations used to treat tennis elbow using the hypospray. Rheumatol. Rehabil., 14, 47.

    Article  PubMed  CAS  Google Scholar 

  • Darlington, L.G. and Coomes, E.N. (1977) The effect of local steroid injections for supaspinatus tears. Rheumatol. Rehabil, 16, 172.

    Article  PubMed  CAS  Google Scholar 

  • Gray, R.G., Kiem, I.M. and Gottlieb, N.K. (1978) Intratendon sheath corticosteroid treatment of rheumatoid arthritis — associated and idiopathic hand flexor tenosynovitis. Arthr. Rheum., 21, 92.

    Article  CAS  Google Scholar 

  • Henderson, E.D. and Henderson, C.C. (1953) The use of hydrocortisone acetate (compound F acetate) in the treatment of post-traumatic bursitis of the knee and elbow. Minnesota Med., 36, 142.

    PubMed  CAS  Google Scholar 

  • Hucherson, D.C. and Freeman, G.E. (1962) Iliopectineal bursitis — a cause of hip pain frequently unrecognised. Am. J. Orthop., 4, 220.

    PubMed  CAS  Google Scholar 

  • Lapidus, P.W. and Grudotti, F.P. (1967) Report on the treatment of one hundred and two ganglions. Bull. Hosp. Joint Dis., 28, 50.

    PubMed  CAS  Google Scholar 

  • Lee, P.N., Lee, M., Haq, A.M.M.M. et al. (1974) Periarthritis of the shoulder: trial of treatments investigated by multivariate analysis. Ann. Rheum. Dis., 33, 116.

    Article  PubMed  CAS  Google Scholar 

  • Miller, J.H., White, J. and Norton, T.H. (1958) The value of intra-articular injections in osteoarthritis of the knee. J. Bone Joint Surg., 40B, 636.

    Google Scholar 

  • Myles, A.B., Casemore, V.A., Couthlard, M. et al. (1973) Management of the carpal tunnel syndrome with local corticosteroid injection. Rheumatol. Rehabil., 12, 205.

    Article  Google Scholar 

  • Rogers, M.H. (1939) Treatment of subdeltoid bursitis. Am. J. Surg., 43, 2929.

    Article  Google Scholar 

  • Sheldon, P. and Beer, P.C. (1973) Synovitis of the knee treated by intra-articular hydrocortisone acetate, hydrocortisone acetate plus saline, or saline alone. A double blind trial. Rheumatol. Rehabil., 12, 73.

    Article  Google Scholar 

  • Swartout, R. and Compere, E.L. (1974) Ischiogluteal bursitis. J. Am. Med. Assoc, 227, 551.

    Article  CAS  Google Scholar 

  • Symonds, G. (1975) Accurate diagnosis and treatment in painful shoulder conditions. J. Int. Med. Res., 3, 261.

    Google Scholar 

  • Williams, M.E., Seifert, M.H., Cuddigan, J.H.P. and Wise, R.A. (1975) Treatment of capsulitis of the shoulder. Rheumatol. Rehabil., 14, 236.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Rheumatology, Nether Edge Hospital, Sheffield, UK

    J. M. H. Moll BSc, DM, PhD, FRCP (Consultant Physician, Head, Honorary Clinical Lecturer)

  2. Sheffield Centre for Rheumatic Diseases, UK

    J. M. H. Moll BSc, DM, PhD, FRCP (Consultant Physician, Head, Honorary Clinical Lecturer)

  3. Rheumatic Diseases, University of Sheffield, UK

    J. M. H. Moll BSc, DM, PhD, FRCP (Consultant Physician, Head, Honorary Clinical Lecturer)

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  1. J. M. H. Moll BSc, DM, PhD, FRCP
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© 1983 J. M. H. Moll

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Moll, J.M.H. (1983). Local injection therapy. In: Management of Rheumatic Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3140-5_7

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  • DOI: https://doi.org/10.1007/978-1-4899-3140-5_7

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