Intra-articular corticosteroids: friend or foe?

Intra-articular corticosteroids were first used in the treatment of musculoskeletal conditions in horses in 1955 [1]. Corticosteroids are still considered the gold standard of intra-articular therapy for tackling inflammatory disorders such as osteoarthritis (OA), synovitis or capsulitis. They are used both to modify clinical signs and to treat disease in sport horse disciplines. As potent anti-inflammatory and analgesic agents, they inhibit the inflammatory process at all levels through reduction of capillary dilation and margination, migration and accumulation of inflammatory cells, as well as inhibition of synthesis and release of several soluble mediators (prostaglandin cascade, IL-1) and the arachidonic cascade ...