Position statements

Intraarticular Injections

Intraarticular injections of cortisone
  1. are indicated for Inflammatory Arthritis where inadequate control has been achieved with DMARD (Disease Modifying Antirheumatic Drugs) or at the outset of DMARD therapy.
  2. Patients with Osteoarthritis may require infrequent injections of corticosteroid into one or two joints, usually the knee.
  3. These procedures should be preferably performed in the doctor's rooms without sedation where less than 4 joints need injection. However there are situations where an admission may be required for injection of multiple joints under anaesthesia / sedation. The physician should have the discretion to decide which patients require sedation and this includes children, anxious patients and those with severe active disease requiring >4 joint injections. Injections for soft tissue rheumatism should be given in the doctor's rooms without sedation. Ultrasound guided injections are widely accepted elsewhere as more accurate and safe however the use thereof is limited to those with appropriate training and equipment.
  4. Injections for the hip require fluoroscopic guidance in a radiologist's rooms. Under exceptional circumstances this will apply