Local corticosteroid injection in iliotibial band friction syndrome in runners

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  • Citation tools Download this article to citation manager Crawshaw Dickon P , Helliwell Philip S , Hensor Elizabeth M A , Hay Elaine M , Aldous Simon J , Conaghan Philip G et al. Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial BMJ 2010; 340 :c3037
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    Certain drugs such as troleandomycin (TAO), erythromycin ( Ery-Tab , EryPed 200), and clarithromycin ( Biaxin ) and ketoconazole ( Nizoral ) can reduce the ability of the liver to metabolize (breakdown) corticosteroids and this may lead to an increase in the levels and side effects of corticosteroids in the body. On the other hand, phenobarbital, ephedrine , phenytoin ( Dilantin ), and rifampin ( Rifadin , Rimactane ) may reduce the blood levels of corticosteroids by increasing the breakdown of corticosteroids by the liver. This may necessitate an increase of corticosteroid dose when they are used in combination with these drugs.

    FDA reviewed a sampling of cases from the FDA Adverse Event Reporting System (FAERS) database, as well as cases in the medical literature of serious neurologic adverse events associated with epidural corticosteroid injections. 2-16  Serious adverse events included death, spinal cord infarction, paraplegia, quadriplegia, cortical blindness, stroke, seizures, nerve injury, and brain edema.  Many cases were temporally associated with the corticosteroid injections, with adverse events occurring within minutes to 48 hours after the corticosteroid injections.  In some cases, diagnoses of neurologic adverse events were confirmed through magnetic resonance imaging or computed tomography scan.  Many patients did not recover from these reported adverse events.

    AB - PURPOSE: To demonstrate the efficacy of local corticosteroid therapy for the treatment of eyelid and orbital xanthogranuloma in adults. METHODS: The authors performed a retrospective chart review of 6 patients receiving local triamcinolone acetonide (40 mg/ml) injections for the treatment of eyelid and orbital xanthogranuloma at the University of Michigan. All patients underwent diagnostic biopsy before treatment. The effects of this therapy on symptoms and signs of the disease were assessed. RESULTS: All 6 patients had eyelid swelling or nodularity and 5 had yellow discoloration of their eyelids. All lesions involved the eyelids and anterior orbit and 5 were present bilaterally. Biopsy revealed necrobiotic xanthogranuloma in 4 patients and adult-onset xanthogranuloma in 2 patients. Triamcinolone acetonide was administered intralesionally as series of 2 to 25 injections. Local control was obtained in all 6 cases, with the reduction of symptoms and signs of the disease in 5 cases. Two patients with necrobiotic xanthogranuloma had development of non-Hodgkin lymphoma. Average follow-up of patients whose treatment was not truncated by systemic chemotherapy was 52 months (range, 30 to 86 months). No complications occurred as a result of this treatment. CONCLUSIONS: Intralesional injection of triamcinolone acetonide is an effective, safe treatment for orbital xanthogranuloma in adults. This modality avoids the side effects associated with systemic corticosteroid or cytotoxic agent therapy.

    Local corticosteroid injection in iliotibial band friction syndrome in runners

    local corticosteroid injection in iliotibial band friction syndrome in runners

    AB - PURPOSE: To demonstrate the efficacy of local corticosteroid therapy for the treatment of eyelid and orbital xanthogranuloma in adults. METHODS: The authors performed a retrospective chart review of 6 patients receiving local triamcinolone acetonide (40 mg/ml) injections for the treatment of eyelid and orbital xanthogranuloma at the University of Michigan. All patients underwent diagnostic biopsy before treatment. The effects of this therapy on symptoms and signs of the disease were assessed. RESULTS: All 6 patients had eyelid swelling or nodularity and 5 had yellow discoloration of their eyelids. All lesions involved the eyelids and anterior orbit and 5 were present bilaterally. Biopsy revealed necrobiotic xanthogranuloma in 4 patients and adult-onset xanthogranuloma in 2 patients. Triamcinolone acetonide was administered intralesionally as series of 2 to 25 injections. Local control was obtained in all 6 cases, with the reduction of symptoms and signs of the disease in 5 cases. Two patients with necrobiotic xanthogranuloma had development of non-Hodgkin lymphoma. Average follow-up of patients whose treatment was not truncated by systemic chemotherapy was 52 months (range, 30 to 86 months). No complications occurred as a result of this treatment. CONCLUSIONS: Intralesional injection of triamcinolone acetonide is an effective, safe treatment for orbital xanthogranuloma in adults. This modality avoids the side effects associated with systemic corticosteroid or cytotoxic agent therapy.

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