Intra-Articular Corticosteroid Injections for Rheumatologic Conditions

Clinical Context and Indications

The European League Against Rheumatism recommends intra-articular corticosteroids as adjunctive therapy in rheumatologic conditions, not primary treatment, for mono- or oligoarthritis in rheumatoid arthritis patients 1
The American College of Rheumatology suggests using intra-articular corticosteroids as bridging therapy while awaiting DMARD efficacy 3, 4
Intra-articular corticosteroids are indicated for persistent synovitis in specific joints despite adequate systemic therapy, according to the European League Against Rheumatism 2

The American College of Rheumatology recommends that methotrexate remains the cornerstone systemic DMARD and should be initiated as soon as RA diagnosis is made 3, 2
Low-dose glucocorticoids (≤10 mg/day prednisone equivalent) can be added systemically for up to 6 months as bridging therapy, as suggested by the American College of Rheumatology 3, 4
Biologic DMARDs (TNF inhibitors, IL-6 inhibitors, abatacept, rituximab) or JAK inhibitors should be added when inadequate response to conventional DMARDs occurs, according to the European League Against Rheumatism 3, 2, 5