Deprecated function: Return type of DatabaseStatementBase::execute($args = [], $options = []) should either be compatible with PDOStatement::execute(?array $params = null): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2246 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::current() should either be compatible with Iterator::current(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::rewind() should either be compatible with Iterator::rewind(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2348 of /var/www/webmd/apps/mdedge/htdocs/includes/database/database.inc).
Case Reports
Extreme Postinjection Flare in Response to Intra-Articular Triamcinolone Acetonide (Kenalog)
Although many cases of corticosteroid hypersensitivity have been reported, in rare cases intra-articular administration of triamcinolone has caused anaphylactic reactions and shock.14,15 Multiple case studies have determined that the specific excipient carboxymethylcellulose (found in many triamcinolone preparations), and not the corticosteroid itself, can cause an immunoglobulin E–mediated anaphylactic reaction.16-18 Therefore, performing skin-prick tests for potential corticosteroids and their excipients in patients with known postinjection flares might help prevent serious adverse reactions.18,19
The present case involved an extreme postinjection flare in response to intra-articular administration of triamcinolone acetonide. Postinjection flares are rare but significant events, and physicians using CSIs in the treatment of arthritis need to be aware of this potential reaction in order to appropriately inform patients of this risk and guide treatment should the scenario arise.
