ABSTRACT
Therapeutic use of corticosteroids is an important but controversial issue in
rheumatology. In 1949, Hench and others, who subsequently shared the Nobel
Prize for their pioneering work, demonstrated the dramatic effects of cortisone for
treating rheumatoid arthritis. Subsequent recognition of the side effects that may
develop from long-term use of supraphysiologic doses dampened enthusiasm for
its use. As late as the 1990s, corticosteroids were not universally recommended
for the treatment of crystal-induced arthritis because of fears of side effects and
concerns about rebound attacks of arthritis after the agents were discontinued.
Although controversies about the use of corticosteroids continue to this date,
these agents remain very effective treatments for many patients with serious
rheumatic diseases. In gout and the crystal-induced arthritides, corticosteroids are
potent and extremely useful therapeutic agents, and, in certain circumstances, are
the agents of choice.