What are some important contraindications to corticosteroid joint injections?
Absolute contraindications to corticosteroid joint injections include local or intraarticular sepsis, bacteremia, intraarticular fracture, and joint instability. If a patient has an infection at the time of corticosteroid injection, the primary concern is introduction of infection into the joint or worsening of a preexisting joint infection. In the setting of fracture and joint instability, corticosteroids inhibit bone healing and lead to worsening of joint instability due to the potential for subchondral osteonecrosis, as well as weakening of the joint capsule and ligaments. Relative contraindications to corticosteroid joint injection include: severe juxtaarticular osteoporosis, coagulopathy, and injection of a joint three times within a year or an injection within the last six weeks.