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Case Report
 
Cushingoid facies from one time intra-articular joint kenalog injection
Justice Otchere1, Chitra Damodaran2, Scott Russel Strum3, Sarfo-Poku Christian4
1MD, Loma Linda University Physical Medicine and Rehabilitation-Resident physician, Loma Linda, CA, USA.
2MD, Loma Linda VA Health System Department of Gastroenterology- Assistant professor, Loma Lind, CA, USA.
3MD, Loma Linda University Physical Medicine and Rehabilitation-Assistant professor, Loma Linda, CA, USA.
4MPH, Loma Linda University, School of Medicine, Loma Linda, CA, USA.

Article ID: 100019Z09JO2016
doi:10.5348/Z09-2016-19-CR-12

Address correspondence to:
Justice Otchere
11406 Loma Linda Drive, Suite 516
Loma Linda, California
USA, 92354

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How to cite this article:
Otchere J, Damodaran C, Strum SR, Sarfo-Poku C. Cushingoid facies from one time intra-articular joint kenalog injection. Edorium J Disabil Rehabil 2016;2:50–54.


Abstract
Introduction: Kenalog (triamcinolone acetonide) corticosteroid injection is a standard procedure for approaching intra-articular joint pain due to mild and severe debilitation and degeneration. A focal intra-articular steroid injection effect is mostly localized in the capsular space. Given the slow absorbance of corticosteroid injection in intra-into the intravascular system, systemic effects are usually not manifested.
Case Report: We report a case of secondary cushingoid features after a one time intra-articular injection of Kenalog (triamcinolone acetonide) preparation in an HIV patient. The patient's HIV medication included a protease inhibitor, which can inhibit the metabolism of the corticosteroid and may contribute to a cushingoid presentation.
Conclusion: Intra-articular corticosteroid injection is not a benign procedure and may lead to extra-articular dysregulation of other organ systems.

Keywords: Corticosteroid, Cushingoid facies, Intra-articular injection, Kenalog


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Author Contributions
Justice Otchere – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Chitra Damodaran – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Scott Russel Strum – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sarfo-Poku Christian – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Justice Otchere et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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