Cushing syndrome, adrenal suppression and local corticosteroid use

Adrenal suppression can occur following use of intra-articular corticosteroid injection for treatment of arthritis. If unrecognised, this can result in major medical illness, shock or death. We report two children who developed Cushingoid features and severe adrenal suppression after joint injection. Paediatricians caring for children who have intra-articular corticosteroid injections should be aware of this potential complication. Monitoring of cortisol levels after injection should be considered.