Steroid injections during the coronavirus pandemic - The Ultrasound Site

Since the development of the global outbreak of the Coronavirus pandemic we have received a number of queries from our community of clinicians and course delegates regarding the administration of steroid injections for musculoskeletal intra-articular and peri-articular pathologies. We are certainly not in a position to develop or state our own guidance, and have no intention to do so. We would however like to provide some support to clinicians to help them take the correct steps when making these challenging decisions. This therefore hopefully provides a summary article including useful links to the main statements from NHS England and UK professional bodies on steroid injections during the coronavirus pandemic.

What have we done

We have taken some time to compile a list of the current advice and guidance within the UK from professional bodies and NHS England. You will notice that there are similarities and repetition of some key points and statements and this is due to the collaborative approach taken when forming such guidance. We did however still feel it helpful to link each MSK stakeholders document or statement that we are aware of, so that you can decide which ones you feel are most relevant to your situation

It may also be helpful to be aware of a number of other musculoskeletal guidance documents that have been released. These do not refer specifically to steroid injections and the administration of them, but more to the overall MSK pathways that currently exist in the UK. We hope this may also be of interest.

Urgent and Emergency Musculoskeletal Conditions Requiring Onward Referral

Clinical guide for the management of patients with musculoskeletal and rheumatic conditions on corticosteroids during the coronavirus pandemic

Urgent and emergency musculoskeletal conditions in children (under 16) requiring onward referral

There are a number of key papers that the guidance documents below refer to and we have tried to compile the relevant links for these below to help you with further reading. Not all these are free full text I am afraid. Please do let us know of any others that you feel would be helpful to list here.

Broersen et al (2015) Adrenal Insufficiency in Corticosteroids Use: Systematic Review and Meta-Analysis

Friedly et al (2018) Systemic effects of epidural steroid injections for spinal stenosis.

Sytsma et al (2018) Joint Corticosteroid Injection Associated With Increased Influenza Risk

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