Corticosteroid injections and arthrocentesis.

OBJECTIVE: To review current standards of practice of arthrocentesis and corticosteroid injections in soft tissue and joints in managing common musculoskeletal conditions. To outline common indications, contraindications, and possible complications of these therapeutic modalities and to describe common techniques used in them.

QUALITY OF EVIDENCE: Many of our recommendations are based on expert opinion and surveys of clinical practice by experts in the field. Where appropriate, randomized controlled trials are used to support various aspects of corticosteroid injection and joint aspiration.

MAIN MESSAGE: Many complaints to primary care physicians are musculoskeletal in origin, and many are related to infectious or inflammatory conditions of joints or soft tissues. Arthrocentesis and intra-articular and soft tissue corticosteroid injection are therapeutic techniques readily available to family practitioners. There is no consensus on best practice for patient preparation, choice of corticosteroid, or specific injection technique. There are, however, accepted standards of practice and universal precautions.

CONCLUSION: Family physicians have an important role in managing many common musculoskeletal conditions.