How to Use Intra-Articular Corticosteroids Appropriately

The action of corticosteroids is exerted through steroid-specific receptors in the cytoplasm of steroidresponsive tissues. This interaction results in the altered transcription of genes, leading to a wide variety of anti-inflammatory effects as well as other effects on the biology of articular cells that are of variable benefit. Corticosteroids are able to suppress inflammation at virtually all levels. The humeral effects of corticosteroids are due to the inhibition of phospholipase A and the decrease in production of proinflammatory mediators by both the cyclooxygenase and lipoxygenase pathways. They also inhibit many of the other inflammatory effects such as capillary dilation, migration of inflammatory cells, and the production and release of degradative enzymes.