A new form of severe acute localized reactions following intra-articular hyaluronic acid injections in knee osteoarthritis. A case report

Intra-articular hyaluronic acid (HA) injections are widely used for the treatment of symptomatic knee osteoarthritis. Adverse reactions were described in a limited number of patients and consist in local inflammatory reactions and severe acute inflammatory reactions (pseudosepsis). We present the case of a 71-year-old woman who experienced a severe acute adverse effect immediately (within minutes) following intraarticular HA administration, attributed to HA precipitation. The severe very early local manifestations were accompanied by important systemic reactions, necessitating treatment with systemic corticosteroids besides joint lavage.