Adverse effects of local corticosteroid injections
Practitioners administering corticosteroids should be mindful not to inject too large a volume, as subcutaneous leakage may occur resulting in systemic and local adverse effects. Systemic adverse effects of local corticosteroid injections include increased blood glucose concentration, sleep disturbance and flushing. Local adverse effects of corticosteroid injections include temporary worsening of musculoskeletal symptoms, skin hypopigmentation and tissue atrophy.
Although tendon rupture has been reported in people injected with corticosteroids, a causal relationship is unproven. Peritendinous corticosteroid injections should be used with caution if the major weightbearing tendons are involved (eg patellar, tibialis posterior and Achilles tendons); consider seeking specialist advice.
Septic arthritis is a rare but serious complication of intra-articular corticosteroid injections.
Corticosteroids can impair linear growth and accrual of bone mass in children, so must always be used with particular care.