Do you avoid intra-articular and bursa/tendon sheath corticosteroid injections in patients with a history of avascular necrosis?

I would give intra-articular or bursa injections of steroids/glucocorticoids in patients with either active ON or a history of GC induced ON. I do not believe the local injection will increase the risk of progression or incident ON, as long as it is not given more often than every 3-4 months.

This is one of those questions where there will be polar differences. @Dr. First Last is correct that there really are no major studies to tell us one way or the other, so I can understand her view.

However, I am concerned that there have been anecdotal reports of osteonecrosis following intra-artic...