Use of Intra-Articular Injection Corticosteroid Injections to the First Metatarsophalangeal Joint. First Theme of a Scoping Review

Introduction: A needle is inserted into a joint for arthrocentesis or injection of a therapeutic medication(s), commonly a corticosteroid. The aim of this paper is to discuss the first theme identified from a scoping review of corticosteroid injections for the pathology of the first metatarsophalangeal joint. Pathology. The two most common pathologies affecting the first metatarsophalangeal joint are osteoarthritis and bunions. An arthritic joint is regularly injected with a corticosteroid, but bunions are not. Other pathologies that may receive an injection include rheumatoid arthritis, gout, sesamoiditis and post-operative arthrofibrosis. Discussion. Most available evidence discusses corticosteroid injections for osteoarthritis, but there is a paucity of high-quality evidence, especially for corticosteroid use in other pathological conditions. Conclusion. Whilst the evidence base suggests that corticosteroid injections are safe short- and mid-term treatment options for a range of soft tissue and joint pathology, the specific indications, and short/long-term outcomes in the first metatarsophalangeal joint pathologies are not clear and warrant further study.