A special report in the journal Radiology says steroids may relieve pain, but might speed up the deterioration of the joint, and the need for total hip and knee replacements.
Physicians often inject anti-inflammatory corticosteroids into the joint to treat the pain and swelling associated with osteoarthritis.
The procedure is widely viewed as safe, and patient consent forms mainly mention the risks of hemorrhage and infection among more rare side effects.
Researchers at Boston University identified complications of the shots they say are being underestimated.
In a review of existing literature, Dr. Ali Guermazi and colleagues identified four main adverse findings: accelerated osteoarthritis progression with loss of the joint space, subchondral insufficiency fractures (stress fractures that occur beneath the cartilage), complications from osteonecrosis (death of bone tissue), and rapid joint destruction including bone loss.
They say doctors should no longer tell patients the injections are harmless.