摘要（以色列）： 关节内注射激素很受欢迎。本综述通过文献综述了解关节内注射激素的局部疗效和副作用。使用“intra-articular”和“ local effect”到PubMed检索，包括主观疗效、功能、结构、细胞、体液、分子和影像学方面，且记录所有的副作用。

结果发现，关节内注射激素的主要益处是缓解疼痛，其持续时间不定，主要取决于潜在疾病、疾病类型、结构损害程度、激素注射量、有无关节积液、炎症介质水平、关节液抽空情况及是否行影像学等。多数情况下，炎症疾病的疼痛和功能改善明显，如幼年特发性关节炎膝关节内注射激素，有超过80%的患者缓解超过6个月，平均约达1.2年，而膝骨关节炎患者的疼痛缓解仅维持3周，类风湿关节炎为8周。骨关节炎患者多次关节内注射激素不导致关节间隙丧失，类风湿关节炎单次关节内注射激素也不增加软骨或骨糜烂。特殊关节内的激素注射如在影像学指导下进行可获得更好的疗效。关节感染率很低，其他副作用包括关节内和关节周围钙化、皮肤萎缩、皮肤色素脱失、缺血性坏死、股骨头快速破坏、急性滑膜炎、charcot关节病、肌腱病、Nicolau病和关节错位。

关节内注射激素有很多的局部疗效，尤其是幼年特发性关节炎患者的主观和功能改善突出，副作用罕见或不明显。

附原文：Abstract Intra-articular corticosteroid injection (IACI) is a very popular procedure. In this review, we wanted to review all that had been published about local effects of IACIs. English literature search was made through PubMed using the terms intra-articular and local effect. Effects on subjective, functional, structural, cellular, humoral, molecular, and imaging aspects were included. Also, all local adverse effects were documented. The main beneficial effect of IACI is pain relief. The duration of this effect is variable and depends on underlying disease, type of disease, amount of structural damage, type of IACI, dose of IACI, presence of joint effusion, level of inflammatory mediators, emptiness of joint effusion, availability of imaging, and others. At large, inflammatory problems had higher rate of favorable response in terms of pain and function. IACI at the knee joint in juvenile idiopathic arthritis patients resulted in remission for >6 months in >80% of the patients with a mean duration of approximately 1.2 years, while in the osteoarthritic knee there was a pain relief for 3 weeks only and in rheumatoid arthritis (RA) knee for 8 weeks. There was no joint space loss at the knee joint following multiple IACI in osteoarthritis and also no increase in cartilage or bone erosions in RA following a single IACI. IACI guide imaging is important in achieving better results in particular joints. Joint infection rate is very low. Other adverse effects included intra-articular and periarticular calcifications, cutaneous atrophy, cutaneous depigmentation, avascular necrosis, rapid destruction of the femoral head, acute synovitis, Charcot's arthropathy, tendinopathy, Nicolau's syndrome, and joint dislocation. IACI is associated with a wide range of local effects. Subjective and functional favorable response is prominent mainly in juvenile idiopathic arthritis patients. Adverse effects are either rare or insignificant.

引自：Habib GS, Saliba W, Nashashibi M. Local effects of intra-articular corticosteroids. Clin Rheumatol. 2010 Apr;29(4):347-56. Epub 2010 Jan 26.