Abstract

Intra-articular steroid injections (IASI) can be associated with decreased release of endogenous cortisol, but are rarely thought to cause adrenal insufficiency (AI) because of the barriers that exist in diagnosing patients with AI secondary to AISI. Such barriers include, misconception that all IASI effects are local, treating only inflammation at the injected joint, failure by patients to recall injections, lack of cushingoid features in patients and presentation with common symptoms including weight gain and fatigue. We present five patients who presented to our center with AI, secondary to IASI.