To the Editor.
—Intra-articular injections of hydrocortisone have now been given in more than 17,000 instances to more than 1,300 arthritic patients at the Hospital of the University of Pennsylvania. Only simple, but careful, "instrument technique" and aseptic precautions were used. In four instances, septic arthritis resulted; this was easily controlled by prompt and adequate antibiotic therapy. The incidence of joint infection in this series, therefore, is less than 1 in 4,000 injections.So that the recent letter published in The Journal for June 5, 1954, page 597, will not cause undue alarm concerning the dangers of this method, I have cited the above statistics. Careful attention to sterilization of the skin overlying the joint and of the syringe and needle to be used are essential, but drapes and gloves have not proved necessary and only make the procedure more complicated.