Intra-articular injections of corticosteroids have been used as a treatment option for degenerative arthritis of the knee for short- to mid-term symptomatic pain relief for many decades. Recently, there have been studies that have reported increased risks of periprosthetic joint infections in patients who have received these injections. In this study, we evaluated the risk of superficial, deep, and overall rate of infections in 302 patients who had received intra-articular corticosteroid infiltration within 12 months before undergoing total knee arthroplasty (TKA) and compared them with a 1:1 matched cohort who had undergone TKA, but who did not have any prior corticosteroid knee injections. At a mean follow-up of approximately 3.5 years after TKA, there were no significant differences in the rate of superficial incisional infections (7 vs. 6 out of 302 patients), deep periprosthetic infections (3 vs. 6 out of 302 patients), and overall infections (10 vs. 12 out of 302 patients) in the two groups. In addition, no significant differences were found in the rate of deep infections when intra-articular corticosteroids were administered 10 weeks to 2 months, 2-4 months, 4-6 months, 6-12 months, and beyond 12 months before surgery. We concluded that intra-articular corticosteroid injections are safe and do not increase the rate of postoperative infections.

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Multiple myeloma is a malignant plasma cell dyscrasia that may invade the orbits in extramedullary presentations. Common manifestations of orbital involvement include unilateral proptosis, injection, chemosis, diplopia, and occasionally pain. Additionally, the soft-tissue tumors associated with multiple myeloma typically cause bony destruction of adjacent structures. However, in certain patients, bilateral proptosis and a lack of bony destruction may occur. In these instances, it is important for physicians to consider patient history, presentation, and progression in order to ensure that a potentially fatal diagnosis is not missed. The reason this case is important is two-fold: 1) we describe a case of an individual with relapsing multiple myeloma presenting as bilateral proptosis and lacking bony destruction, highlighting the importance of understanding the disease process and 2) we discuss why patients with multiple myeloma may be more prone to developing tumors of the orbit in recurrent cases.

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