{
  "abstract": "Background Corticosteroid injections (CSIs) are widely employed in facet and sacroiliac joint pain. Similar to CSIs at other sites (peripheral nerve blocks, joints, epidural), these injections are associated with potential adverse events. These multisociety consensus recommendations aim to develop evidence-based statements and recommendations on the safe use of CSIs in facet joint and sacroiliac joint injections.Methods Development of the consensus recommendations was approved by the American Society of Regional Anesthesia and Pain Medicine Board of Directors and several other societies that agreed to participate. The scope of statements and recommendations was agreed on to include safety of the injection technique (landmark-guided, ultrasound, or radiology-aided injections); effect of the addition of the corticosteroid on effectiveness (vs local anesthetic or saline); and adverse events related to the injection. Experts were assigned topics to perform a comprehensive literature review and draft statements and recommendations, which were refined and voted for consensus (>75% agreement) using a modified Delphi process. A modified version of the US Preventive Services Task Force grading of evidence and strength of recommendation was followed.Results All statements and recommendations were approved by all participants after four rounds of discussion. The Practice Guidelines Committees and Boards of Directors of the participating societies also approved all statements and recommendations. Injection of corticosteroid into the facet joint in patients with joint inflammation may relieve pain and improves function. Intra-articular, extra-articular (periarticular), and combined administration are effective for sacroiliac joint injections. No dose-response studies exist, but CSIs containing 10 mg of methylprednisolone or triamcinolone per facet joint and 40 mg per sacroiliac joint (SIJ) (or their respective pharmacologic equivalents) are reasonable.Conclusions In this practice recommendation, we provide statements and recommendations on facet and sacroiliac joint CSIs, the optimal doses, and intervals and criteria for repeating the CSIs in patients with facet joint and sacroiliac joint pain.",
  "authors": [
    {
      "affiliations": [
        "Departments of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"
      ],
      "name": "Honorio T Benzon"
    },
    {
      "affiliations": [
        "Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Tina L Doshi"
    },
    {
      "affiliations": [
        "Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Tim Maus"
    },
    {
      "affiliations": [
        "Medicine (Rheumatology), UCLA, Los Angeles, California, USA"
      ],
      "name": "John FitzGerald"
    },
    {
      "affiliations": [
        "Medicine (Endocrinology), Walter Reed National Military Medical Center, Bethesda, Maryland, USA"
      ],
      "name": "Thanh D Hoang"
    },
    {
      "affiliations": [
        "Anesthesiology, Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USA"
      ],
      "name": "Hariharan Shankar"
    },
    {
      "affiliations": [
        "Anesthesiology, The University of Texas Health Science Center, San Antonio, Texas, USA"
      ],
      "name": "Maged Mina"
    },
    {
      "affiliations": [
        "Anesthesiology, The University of Kansas Medical Center, Kansas City, Kansas, USA"
      ],
      "name": "Andrea Chadwick"
    },
    {
      "affiliations": [
        "Anesthesiology, The University of Texas Health Science Center, San Antonio, Texas, USA"
      ],
      "name": "Maxim S Eckmann"
    },
    {
      "affiliations": [
        "Department of Anesthesia, University of Chicago Medical Center, Chicago, Illinois, USA"
      ],
      "name": "Dalia Elmofty"
    },
    {
      "affiliations": [
        "Anesthesiology - Pain Medicine, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Christine Hunt"
    },
    {
      "affiliations": [
        "PM&R, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Ameet Nagpal"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, University of California Irvine, Irvine, California, USA"
      ],
      "name": "Ariana M Nelson"
    },
    {
      "affiliations": [
        "Anesthesiology, Naval Medical Center San Diego, San Diego, California, USA"
      ],
      "name": "Carlos Pino"
    },
    {
      "affiliations": [
        "Department of Anesthesia, University of Chicago Medical Center, Chicago, Illinois, USA"
      ],
      "name": "Maunak Rana"
    },
    {
      "affiliations": [
        "Orthopedic Surgery, LSUHSC, New Orleans, Louisiana, USA"
      ],
      "name": "Jessica Rivera"
    },
    {
      "affiliations": [
        "PM&R, Vanderbilt University Medical Center, Nashville, Tennessee, USA"
      ],
      "name": "Byron Schneider"
    },
    {
      "affiliations": [
        "Pain Medicine, Western Reserve Hospital Partners, Cuyahoga Falls, Ohio, USA"
      ],
      "name": "Dmitri Souza"
    },
    {
      "affiliations": [
        "Physical Medicine and Rehabilitation, Cleveland Clinic Neurological Institute, Cleveland, Ohio, USA"
      ],
      "name": "Alison Stout"
    },
    {
      "affiliations": [
        "Anesthesia, McMaster University, Hamilton, Ontario, Canada"
      ],
      "name": "Harsha Shanthanna"
    },
    {
      "affiliations": [
        "University Hospitals of Cleveland, Cleveland, Ohio, USA"
      ],
      "name": "Samer Narouze"
    },
    {
      "affiliations": [
        "University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Ajay D Wasan"
    },
    {
      "affiliations": [
        "Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA"
      ],
      "name": "David Anthony Provenzano"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Physical Medicine & Rehabilitation, Neurology, Psychiatry and Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"
      ],
      "name": "Steven Paul Cohen"
    }
  ],
  "title": "Multisociety multispecialty consensus recommendations on corticosteroid injections for facet joint and sacroiliac joint pain",
  "uid": "9b787b80-8932-535d-a116-e1accd250c58"
}