PubMed1993
The author in the article in the form of an assembled report deals with the problem of intraarticular and periarticular injection therapy. The author divides the matter in two parts, the diagnostics and therapy. In general, there are four possibilities of influencing the joint by means of an injection. First, the evacuation of intraarticular contents, second, the introducing of pharmacy into the joint, third, the mechanical irritation of certain connective tissue structures of the joint which ought to evoke the formation of a scar, and fourth, the mechanical stabilization of the structure inflicted by lesion. Owing to the removal of pain, the negative effects of neuromuscular reflexes due to algesic stimuli, are eliminated. There are two basic types of affections subjectable to injection intraarticular treatment, namely the diseases coinciding with the damage of articular biomechanics, particularly disturbances of both, the sliding in arthrosis and articular stability. In such cases the application of chondroprotectives, eventually formation of a scar by irritation of the appropriate connective tissue structures, decreasing of instability and removal of contractures are theoretically justified. Evacuation punction is indicated in post-traumatic states, inflammatory states indicate diagnostic punction, and aseptic inflammation requires infiltration of pharmacy with antiphlogistic effect. Injection intrarticular intervention represents a justified diagnostic procedure and an effective therapeutical administration. It is necessary to become familiar with the topographic anatomy of joints, just as with the technique of application, contraindications, and determination of possible limitations of intraarticular treatment and surgical reconstructive intervention into the joint or extremity. The most serious complications of intraarticular injection administration are represented by iatrogenic infections and cortisone-like arthropathies.(ABSTRACT TRUNCATED AT 250 WORDS)