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Musculoskeletal corticosteroid injections: Recommendations of the French Society for Rheumatology (SFR) - 05/03/23

Doi : 10.1016/j.jbspin.2022.105515 
Yves Maugars a, , Hervé Bard b, Augustin Latourte c, Éric Senbel d, René-Marc Flipo e, Florent Eymard f

a French group multidisciplinary experts in interventional rheumatology

a Service de rhumatologie, CHU Nantes, Nantes, France 
b Rhumatologie, Paris, France 
c Service de rhumatologie, CHU Lariboisière, Paris, France 
d Rhumatologie, Marseille, France 
e Service de rhumatologie, CHU Lille, Lille, France 
f Service de rhumatologie, CHU Henri-Mondor, Paris, France 

Corresponding author. Service de rhumatologie, CHU Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.Service de rhumatologie, CHU Nantes1, place Alexis-RicordeauNantes44093France

Highlights

Corticosteroid injections are a standard practice seeing increasing use.
The choice of which corticosteroids to use and their availability is an on-going discussion.
Technical advances and very rare complications justify updating our practices.
A group of multidisciplinary experts has drawn up 13 consensus-based recommendations.
The role of corticosteroid injections must be defined relative to new joint regenerative therapies.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Musculoskeletal corticosteroid injections are widely performed, although the exact practice varies greatly due to advances in knowledge and techniques. This justifies updating and drawing up good practice recommendations. Using a consensus model formalized by the French National Authority for Health (HAS) and based on a literature review that resulted in a “white book”, 13 recommendations were developed by a group of experts. These recommendations were then sent online to 48 specialists for evaluation, 27 of whom were rheumatologists and 15 of whom were general practitioners. These recommendations were also presented at the 34th annual meeting of the French Society for Rheumatology (SFR) (Paris, December 2021) at a symposium attended by a hundred or so rheumatologists, who voted on these recommendations in person. The results are presented as an overall score out of 10, a median out of 10 and as tertiles. The agreement was excellent for 10 of these 13 recommendations, with mean values of 8.5 to 9.1 out of 10, median values of 9 or 10 out of 10 and agreement of 91.7% to 97.9%, which corresponds to a consensus. The 3 other recommendations were broadly supported but were the subject of more debate. One relates to patient information (mean 7.3/10, median 8/10, upper tertile 72.9%) with discussion about the waiting period. Another related to the summary report (mean 8.4/10, median 9, upper tertile 91.7%) with discussions about its content and the need to specify the lot number of the injected product. The last one related to periprosthetic injections and the need to consult and get approval from a specialist (mean 8.0/10, median 8, upper tertile 83.3%) with mostly the general practitioners having reservations. In all, there is a very strong consensus among the musculoskeletal corticosteroid injection experts and specialists consulted, which justifies them being taken into consideration to improve our daily practice.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Cortisone injection, Injection, Corticosteroids, Recommendations


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© 2022  Pubblicato da Elsevier Masson SAS.
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Vol 90 - N° 2

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