Charcot's Arthropathy Following Intra-articular Hydrocortisone

Steroid Arthropathy of the Hip

“…Case 2 received only three injections into her hip, but nevertheless rapid and severe joint destruction developed. The only other patient recorded in the literature to have developed similar changes after intraarticular injection alone required 18 monthly injections before developing the typical arthropathy (Chandler et al, 1959). Conclusion Ever since cortisone and its equivalents became freely available in Great Britain the use of corticosteroids in both hospital and general practice has increased.…”

“…Pietrograndi and Mastromarino (1957) have reported such hip destruction in a woman treated for four years with cortisone by mouth in a dose of 100 mg. daily. A similar change in the osteoarthritic hip of a patient who received 18 intraarticular injections of 50 mg. hydrocortisone at monthly intervals has been reported by Chandler et al (1959). Others have been recorded by Murray (1960) and Sweetnam (1960).…”

“…Chandler and Wright (1958) were the first, however, to draw attention to similar damage which might occur after intra-articular injection of hydrocortisone in the absence of infection. They demonstrated considerable radiological deterioration, in spite of relief of pain, after injection of hydrocortisone into the knees of patients suffering from rheumatoid arthritis, and concluded that such treatment was " potentially dangerous."…”

Methylprednisolone Acetate in Intra-articular Therapy

“…Chromatographic studies of the persistence of the steroid favour methylprednisolone acetate, but this compound had a higher relapse rate. Chandler et al (1958Chandler et al ( , 1959 have shown that progressive joint deterioration may occur after repeated injections of hydrocortisone preparations, and suggest that radiological control is desirable. One of their osteoarthritic patients developed changes resembling a Charcot arthropathy.…”

Análise fotocolorimétrica computadorizada dos efeitos da betametasona intra-articular sobre a concentração de proteoglicanos da matriz cartilaginosa de joelhos leporinos: influência do número de injeções intra-articulares

“…However, the rapid relief of symptoms, as well as the restoration of the functional levels of joints, eventually led to the indiscriminate use of those drugs. Case reports of Charcot's arthropathy, bone necroses and an increase in articular cartilage degeneration were prominent in the years following the introduction of that modality of treatment 1,2 . Experimentally, corticosteroids cause lesions in the cartilage tissue by inducing proteoglycan loss, a fact that plays a key role in the degeneration of articular cartilages.…”