Freire Véronique, Bureau Nathalie J
Radiology Department, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
Semin Musculoskelet Radiol. 2016 Nov;20(5):401-408. doi: 10.1055/s-0036-1594286. Epub 2016 Dec 21.
Corticosteroids are routinely injected into soft tissues, tendon sheaths, bursae, and joints. These anti-inflammatory agents have different potency and solubility, and solubility is inversely correlated with the duration of action. Corticosteroids carry a low risk of complications but commonly cause systemic and local adverse effects. The use of intra-articular corticosteroid injections in the treatment of inflammatory arthritis and osteoarthritis is well established. Evidence also supports the use of injectable corticosteroids in the treatment of inflammatory tenosynovitis and bursitis associated with rheumatic diseases, trigger finger and de Quervain disease, and carpal tunnel syndrome. The role of corticosteroid injections in the management of rotator cuff disease remains unclear. Strong scientific evidence indicates that corticosteroid injections for lateral epicondylosis worsen the long-term outcomes of patients. This review article discusses the considerations related to the use of corticosteroid injections in the management of nonspinal musculoskeletal conditions.
皮质类固醇通常被注射到软组织、腱鞘、滑囊和关节中。这些抗炎药物具有不同的效力和溶解度,且溶解度与作用持续时间呈负相关。皮质类固醇引起并发症的风险较低,但通常会导致全身和局部不良反应。关节内注射皮质类固醇治疗炎性关节炎和骨关节炎已得到充分认可。有证据也支持注射用皮质类固醇用于治疗与风湿性疾病相关的炎性腱鞘炎和滑囊炎、扳机指和桡骨茎突狭窄性腱鞘炎以及腕管综合征。皮质类固醇注射在肩袖疾病管理中的作用仍不明确。有力的科学证据表明,注射皮质类固醇治疗外侧上髁炎会使患者的长期预后恶化。这篇综述文章讨论了在非脊柱肌肉骨骼疾病管理中使用皮质类固醇注射的相关注意事项。