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Effect of dose of the corticosteroid injected locally on inflammatory diseases

Ahmadzadeh Heshmati, Afshin MDa; Ilka, Shahab MDb

doi: 10.1097/BCO.0000000000000734
ORIGINAL RESEARCH
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Background: Local injection of corticosteroid medication is one of the most common therapeutic treatments in inflammatory diseases, yet there are still many controversies surrounding its use.

Methods: One hundred and seventy patients with de Quervain disease, lateral epicondylitis, or plantar fasciitis were entered into the study and divided into two groups (groups 1 and 2) according to doses of the steroids (20 mg and 40 mg methylprednisolone acetate, respectively). Patients were evaluated before injection and at 3 wk and 6 wk after injection using a visual analogue scale, quick Disabilities of the Arm, Shoulder and Hand score, the American Orthopedic Foot and Ankle Society Score, and grip strength. Complications were recorded at each visit.

Results: All outcome parameters significantly improved 3 wk after injection in all patients. Improvement between weeks 3 and 6 was not significant. There was no significant difference between patients in group 1 and 2 except patients in group 1 with plantar fasciitis had better outcome than those in group 2 at 6 wk. The only encountered complication was change in color of the skin in three patients.

Conclusions: A 20-mg injection of methylprednisolone acetate locally was sufficient for improvement of symptoms in patients with de Quervain disease, lateral epicondylitis, and plantar fasciitis. More doses of the steroid had no more beneficial effect.

aOrthopaedics and Fellowship of Spine Surgery, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

bOrthopaedics and Fellowship of Pediatric Orthopaedics, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran

Financial Disclosure: The authors report no conflicts of interest.

Correspondence to Afshin Ahmadzadeh Heshmati, MD, Assistant Professor of Orthopaedics and Fellowship of Spine Surgery, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran Tel: +989133419527; fax: +983432231969; e-mail: aahorthoped@yahoo.com.

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