When would intra-articular corticosteroid injection be considered in TMD?

• A. In all TMJ disorders
• B. In selected cases of inflammatory TMJ disorders and degenerative OA with persistent pain despite conservative therapy; caution
• C. Never
• D. Only after surgical reconstruction

Answer: (B)

Intra-articular corticosteroid injections are used when the TMJ shows inflammatory or degenerative changes with persistent pain despite good conservative care. They target the inflammatory processes inside the joint, helping to reduce synovitis, effusion, and pain so movement improves. This makes them appropriate for selected inflammatory TMJ disorders and degenerative osteoarthritis that continue to bother the patient after non-surgical treatments have been tried. They are not a blanket treatment for every TMJ disorder, and they aren’t a routine option after surgery. Careful use is important because injections carry risks such as infection, potential cartilage or soft tissue damage with repeated use, and systemic effects.