What to tell your doctor before the visit

Say which medicines and health issues apply

Say if you take blood thinners. Mention diabetes, a bleeding problem, or an active infection. Don't leave out a skin or urinary infection. A shot puts a needle through the skin into the joint.

A short blood sugar rise can follow cortisone. The size and length of that rise can vary. Your doctor needs to know how your diabetes is doing. Ask what plan to follow after the visit.

Share any past trouble after a joint procedure. Say which substance was used if you know it. Describe the reaction in your own words. A medical label isn't needed.

Give the dates that may change timing

Give the doctor any booked knee replacement date. A shot within three months before surgery can raise infection concern. Your surgeon and doctor need the exact dates. Don't try to settle the timing on your own.

Also say if the knee already has an artificial joint. New soreness there calls for a separate exam. Fever, heat, or swelling means you need care sooner. It isn't the time to book a routine shot.

Bring notes from your surgeon if you have them. Your visit will be clearer when both offices have the same dates. Ask who will contact the surgeon if needed. Then you'll know who is handling the next call.

Report warning signs before discussing a shot

Say at once if the knee feels hot and looks swollen. Mention fever, sudden weakness, or new numbness. A knee that won't bear weight also needs attention. Tell the doctor before any knee shot is discussed.

Report night sweats or weight loss as well. Also mention severe night soreness that keeps worsening. Don't smooth over a fast change because the visit was booked earlier. The new symptoms matter more than the booked visit.

Until you get answers, avoid activity that sharply worsens the knee. Keep your notes and medicine list ready. These facts help your doctor decide what needs checking first.

Sources

1. A review of ten studies found single local corticosteroid injections caused a significant but TRANSIENT rise in blood glucose in patients with diabetes, with no adverse reactions or complications reported, and concluded such injections are most likely safe in people whose diabetes is well controlled.

   Waterbrook AL, et al. — Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review.. Sports Health, 2017. DOI: 10.1177/1941738117702585.

2. A meta-analysis found ipsilateral intra-articular corticosteroid injection within 3 months BEFORE joint arthroplasty was associated with increased periprosthetic joint infection risk, and the authors recommend against performing arthroplasty on a joint injected within that window - while injections given at any time overall showed no such association.

   Lai Q, et al. — Prior Intra-articular Corticosteroid Injection Within 3 Months May Increase the Risk of Deep Infection in Subsequent Joint Arthroplasty: A Meta-analysis.. Clin Orthop Relat Res, 2022. DOI: 10.1097/CORR.0000000000002055.

3. A 2017 MMWR outbreak report describes 41 cases of septic arthritis following intra-articular injections given during 250 patient visits at a single New Jersey outpatient practice, 30 (73%) of whom needed surgery; recovered organisms were oral flora and the investigation found multiple breaches of infection-prevention practice.

   Ross K, et al. — Outbreak of Septic Arthritis Associated with Intra-Articular Injections at an Outpatient Practice - New Jersey, 2017.. MMWR Morb Mortal Wkly Rep, 2017. DOI: 10.15585/mmwr.mm6629a3.

4. A 2024 AJR review of corticosteroid injection side effects lists local effects (post-injection flare, skin hypopigmentation and atrophy, infection, tendon rupture, accelerated osteoarthritis progression, osseous injury) and systemic effects (adrenal suppression, facial flushing, hypertension, hyperglycaemia, osteoporosis), and calls for targeted pre-injection counselling for specific populations.

   Kamel SI, et al. — Local and Systemic Side Effects of Corticosteroid Injections for Musculoskeletal Indications.. AJR Am J Roentgenol, 2024. DOI: 10.2214/AJR.23.30458.

5. The 2019 ACR/Arthritis Foundation OA guideline makes a STRONG recommendation for intra-articular glucocorticoid injection in knee OA, alongside strong recommendations for exercise, weight loss, self-management, tai chi, cane use, bracing and NSAIDs; intra-articular steroid injection for HAND OA is only conditionally recommended.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

6. A 2021 JAMA review of hip and knee osteoarthritis places intra-articular steroid injections as providing SHORT-TERM pain relief within a management model whose cornerstones are exercise, weight loss if appropriate and education, complemented by topical or oral NSAIDs, with joint replacement reserved for advanced symptoms and structural damage.

   Katz JN, et al. — Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review.. JAMA, 2021. DOI: 10.1001/jama.2020.22171.