Severe arthralgias after wide fluctuation in corticosteroid dosage.

A clinical syndrome consisting of severe acute nocturnal knee arthralgias, absent signs of inflammation, and spontaneous resolution in 12 to 72 h was observed in 3 patients in close temporal relationship to wide swings in corticosteroid dosage. A similar clinical picture has previously been described in several renal transplant recipients. With increasing use of pulse corticosteroid treatment for a variety of medical and surgical conditions, this disorder is likely to be encountered in many different settings and deserves recognition because of its dramatic presentation and self-limited course.