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June 5, 1954


JAMA. 1954;155(6):597. doi:10.1001/jama.1954.03690240063028

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To the Editor:  —An article by Hollander likens the intra-articular injection of hydrocortisone in its simplicity to a venipuncture (Ann. Int. Med.39:735 [Oct.] 1953). He outlines his technique for injection into a joint and advocates ordinary aseptic precautions without the use of gloves and without draping the site. I feel it imperative to call attention to six cases of septic arthritis that occurred after precisely this technique was followed by several physicians.It is important to recognize that the joints into which these injections are given are not normal joints and that their resistance to infection is considerably lowered by the disease process and the attendant circulatory impairment. The penalties for enthusiastic welcome of new drugs and their administration manifest themselves in proportion to their popular use. Side-effects, sensitivities, and other complications soon are appreciated, and their wholehearted initial acceptance is counter-balanced. The availability of a drug that

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