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Logo of procrsmedFormerly medchtJournal of the Royal Society of MedicineProceedings of the Royal Society of Medicine
 
Proc R Soc Med. 1977 July; 70(7): 461–463.
PMCID: PMC1543126

Use and misuse of intra-articular corticosteroids in treatment of temporomandibular joint pain.

Abstract

In certain cases of intractable pain in the temporomandibular joint after conservative treatments have been unsuccessful, a single intra-articular injection of up to 40 mg of prednisolone trimethylacetate has been shown to be useful for permanent relief. This treatment has most success in patients over the age of 30 years; the older the patient the greater likelihood of clinical improvement. It is not to be recommended in the younger age groups. There is no evidence that a single intra-articular injection of any such corticosteroid causes damage that can be detected radiographically to an apparently sound articular surface. But it is still possible that multiple injections can cause damage, and they should not be used for any age group. In some cases where there is radiographic evidence of articular erosion before treatment, an advance of the lesion with reduction of the size of the mandibular condyle can be expected but is consistent with a reduction of the symptoms. The final result may be said to resemble a pharmacologically-achieved arthroplasty. Judgment of the success of the treatment by symptomatic assessment has proved to be entirely satisfactory, since the majority of patients have been grateful for the initial and continued relief of their pain and dysfunction. They have, in fact, avoided surgery to their joints and have no untoward side-effects.

Full text

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • CHANDLER GN, WRIGHT V, HARTFALL SJ. Intra-articular therapy in rheumatoid arthritis: comparison of hydrocortisone tertiary butyl acetate and hydrocortisone acetate. Lancet. 1958 Sep 27;2(7048):659–661. [PubMed]
  • Gibson T, Burry HC, Poswillo D, Glass J. Effect of intra-articular corticosteroid injections on primate cartilage. Ann Rheum Dis. 1977 Feb;36(1):74–79. [PMC free article] [PubMed]
  • Keagy RD, Keim HA. Intra-articular steroid therapy: repeated use in patients with chronic arthritis. Am J Med Sci. 1967 Jan;253(1):45–51. [PubMed]
  • Salter RB, Gross A, Hall JH. Hydrocortisone arthropathy--an experimental investigation. Can Med Assoc J. 1967 Aug 19;97(8):374–377. [PMC free article] [PubMed]
  • Toller PA. Temporomandibular capsular rearrangement. Br J Oral Surg. 1974 Mar;11(3):207–212. [PubMed]

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