Musculoskeletal corticosteroid injections: Recommendations of the French Society for Rheumatology (SFR) |
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| Affiliation: | 2. Rhumatologie, Paris, France;3. Service de rhumatologie, CHU Lariboisière, Paris, France;4. Rhumatologie, Marseille, France;5. Service de rhumatologie, CHU Lille, Lille, France;6. Service de rhumatologie, CHU Henri-Mondor, Paris, France;1. Service de rhumatologie, CHU Nantes, Nantes, France;2. Rhumatologie, Paris, France;3. Service de rhumatologie, CHU Lariboisière, Paris, France;4. Rhumatologie, Marseille, France;5. Service de rhumatologie, CHU Lille, Lille, France;6. Service de rhumatologie, CHU Henri-Mondor, Paris, France;1. Service de rhumatologie, hôpital Avicenne, APHP, Bobigny, France;2. Inserm U1125, Bobigny, France;3. Université Sorbonne Paris Nord, UFR SMBH, Li2P, Bobigny, France;1. Rheumatology department, Pitié Salpêtrière hospital, AP–HP, 75013 Paris, France;2. Sorbonne Université, Inserm UMRS 1136, Institut Pierre Louis d’Épidémiologie et de Santé Publique, 75013 Paris, France;1. Medicine Service, VA Medical Center, 510, 20th street South, FOT 805B, Birmingham, AL 35233, USA;2. Department of Medicine at School of Medicine, University of Alabama at Birmingham, 1720 Second Ave. South, Birmingham, AL 35294-0022, USA;3. Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, 1720 Second Ave. South, Birmingham, AL 35294-0022, USA;1. Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Via Giustiniani, 2, 35128 Padova, PD, Italy;2. ULSS 6 Euganea Company, Padova, Italy;3. Internal Medicine Unit I, Ca’ Foncello Hospital, Treviso, Italy;1. Rheumatology Dpt, Cochin hospital, Paris Cité University, Paris, France;2. Radiology B, Cochin hospital, Paris Cité University, Paris, France;3. RAISE Reference Centre for Rare Diseases, Paediatric immunology-haematology and rheumatology unit, Necker-Enfants Malades hospital, Assistance Publique-Hôpitaux de Paris, Paris, France |
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| 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. |
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| Keywords: | Cortisone injection Injection Corticosteroids Recommendations |
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