IA Steroid in OA — SCE Rheumatology MCQ
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Correct answer: E — Consider them when other pharmacological treatments are ineffective or unsuitable, or to support therapeutic exercise, explaining that relief lasts about 2 to 10 weeks.
Explanation lettering: D = shown as A · A = shown as B · B = shown as C · C = shown as D
The correct answer is E. NICE recommends considering an intra-articular corticosteroid injection when other pharmacological treatments are ineffective or unsuitable, or when short-term symptom control would support participation in therapeutic exercise. Patients should be told that benefit is temporary, typically lasting 2–10 weeks. Therapeutic exercise, together with weight management when appropriate, remains a core treatment, so injections are not first-line substitutes for exercise (B). They may be used before consideration of joint replacement and are not reserved for failed surgery (A). NICE recognises possible short-term benefit, making C incorrect. Fixed monthly maintenance injections are not recommended, and corticosteroids have not been shown to prevent structural progression (D).
Reference: National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management (NG226), recommendation 1.4.10. 2022. https://www.nice.org.uk/guidance/ng226/chapter/recommendations