Page 102 - Athletic Health Handbook
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patients who had received corticos- fat loss have been described as well.8 which may be secondary to the
teroid injections on a weekly to Loss of skin pigmentation has been mixture of steroid suspension with
monthly basis over a period of reported and patients should be the local anesthetic preservatives.
months to years. Most surgeons alerted to this possible side effect,14 Finally, rare reports of dysphoria,
currently recommend injections at especially in dark-complected indi- nausea, transient extremity weakness,
a minimum of three months apart viduals. Fortunately, this change in and hypersensitivity reactions have
as well as avoidance of repeat injec- skin pigment may be reversible. Some also occurred, but the clinical signifi-
tions over a short period of time. authors recommend changing needles cance of these symptoms is uncertain.
Due to the potential negative effects prior to injection so that material
on hyaline cartilage in weight-bear- does not leak into the subcutaneous Summary
ing joints, avoidance of high impact needle track during injection.
activities is recommended for Injectable corticosteroids have been
24–48 hours following an intra- Facial flushing may also occur used in the care of athletes and
articular injection. with intra-articular corticosteroid nonathletes for a number of years.
injection. This usually occurs within Their efficacy is widely recognized
Due to concerns of ligament and hours and may be present for up to despite the limited number of
tendon disruption, corticosteroids 48 hours.14 The flushing reaction randomized, clinical trials justifying
should be injected within the tendon appears to be more common with their use. Clinicians should be
sheath and not within the tendon/ triamcinolone preparations. cognizant of their biologic effects and
ligament substance. Repeat injections recognize the potential complications
into the tendon sheaths are to be Additional side effects may occur. these agents possess. They should be
avoided if possible due to concerns Joint capsule calcification has been judiciously employed as just one
of tendon/ligament degeneration and noted as an incidental finding espe- component of the overall treatment
subsequent connective tissue failure. cially within the interphalangeal and rehabilitation of the condition
joints. Chalk-like material has also for which they are being used.
Skin atrophy and subcutaneous been noted incidentally at surgery

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