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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mrj</journal-id><journal-title-group><journal-title xml:lang="ru">Современная ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Modern Rheumatology Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1996-7012</issn><issn pub-type="epub">2310-158X</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1996-7012-2023-4-120-137</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-1447</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СОВЕТ ЭКСПЕРТОВ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EXPERT ADVICE</subject></subj-group></article-categories><title-group><article-title>Локальная инъекционная терапия в комплексном лечении болезней костно-мышечной системы: основные принципы использования, доказательная база, безопасность</article-title><trans-title-group xml:lang="en"><trans-title>Local injection therapy in the complex treatment of musculoskeletal disorders: principles of application, evidence base, safety</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6068-3080</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лила</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lila</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кафедра ревматологии ФГБОУ ДПО «РМАНПО» Минздрава России.</p><p>115522, Москва, Каширское шоссе, 34А; 125993, Москва, ул. Баррикадная, 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Department of Rheumatology Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia.</p><p>34A, Kashirskoe Shosse, Moscow 115522; 2/1, Barrikadnaya Street, Build. 1, Moscow 125993</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6736-9772</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Загородний</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zagorodniy</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>127299, Москва, ул. Приорова, 10</p></bio><bio xml:lang="en"><p>10, Priorova Street, Moscow 127299</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1391-0711</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Каратеев</surname><given-names>А. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Karateev</surname><given-names>A. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Каратеев Андрей Евгеньевич.</p><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>Andrey E. Karateev.</p><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><email xlink:type="simple">aekarat@yandex.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7017-0898</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алексеева</surname><given-names>Л. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Alekseeva</surname><given-names>L. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кафедра ревматологии ФГБОУ ДПО «РМАНПО» Минздрава России.</p><p>115522, Москва, Каширское шоссе, 34А; 125993, Москва, ул. Баррикадная, 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Department of Rheumatology Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia.</p><p>34A, Kashirskoe Shosse, Moscow 115522; 2/1, Barrikadnaya Street, Build. 1, Moscow 125993</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8051-8659</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чичасова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chichasova</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кафедра ревматологии ФГБОУ ДПО «РМАНПО» Минздрава России.</p><p>115522, Москва, Каширское шоссе, 34А; 125993, Москва, ул. Баррикадная, 2/1, стр. 1</p></bio><bio xml:lang="en"><p>Department of Rheumatology Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia.</p><p>34A, Kashirskoe Shosse, Moscow 115522; 2/1, Barrikadnaya Street, Build. 1, Moscow 125993</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3375-9879</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лазишвили</surname><given-names>Г. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Lazishvili</surname><given-names>G. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>1, Ostrovitianov Street, Moscow 117997</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4910-8835</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ахтямов</surname><given-names>И. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Akhtyamov</surname><given-names>I. F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>420064, Казань, Оренбургский тракт, 138</p></bio><bio xml:lang="en"><p>138, Orenburgsky Trakt, Kazan 420064</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7938-1536</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бялик</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Bialik</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5626-7404</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макаров</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Makarov</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8218-3223</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Таскина</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Taskina</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8814-9704</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шмидт</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Schmidt</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>119049, Москва, Ленинский проспект, 8</p></bio><bio xml:lang="en"><p>8, Leninsky Prospect, Moscow 119049</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6655-5592</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крылов</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Krylov</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>249036, Обнинск, ул. Маршала Жукова, 10</p></bio><bio xml:lang="en"><p>10, Marshal Zhukov Street, Obninsk 249036</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3745-0924</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бялик</surname><given-names>В. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Bialik</surname><given-names>V. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7179-8174</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нестеренко</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nesterenko</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34А</p></bio><bio xml:lang="en"><p>34A, Kashirskoe Shosse, Moscow 115522</p></bio><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБУ «Национальный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. Приорова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.N. Priorov National Medical Research Center of Traumatology and Orthopedics</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ГАУЗ «Республиканская клиническая больница Министерства здравоохранения Республики Татарстан»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ГБУЗ «Городская клиническая больница № 1 им. Н.И. Пирогова Департамента здравоохранения города Москвы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.I. Pirogov City Clinical Hospital №1 of Moscow City Health Department</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>Медицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A.F. Tsyba Medical Radiological Research Center, branch of National Medical Research Center for Radiology, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>18</day><month>08</month><year>2023</year></pub-date><volume>17</volume><issue>4</issue><fpage>120</fpage><lpage>137</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лила А.М., Загородний Н.В., Каратеев А.Е., Алексеева Л.И., Чичасова Н.В., Лазишвили Г.Д., Ахтямов И.Ф., Бялик Е.И., Макаров М.А., Таскина Е.А., Шмидт Е.И., Крылов В.В., Бялик В.Е., Нестеренко В.А., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Лила А.М., Загородний Н.В., Каратеев А.Е., Алексеева Л.И., Чичасова Н.В., Лазишвили Г.Д., Ахтямов И.Ф., Бялик Е.И., Макаров М.А., Таскина Е.А., Шмидт Е.И., Крылов В.В., Бялик В.Е., Нестеренко В.А.</copyright-holder><copyright-holder xml:lang="en">Lila A.M., Zagorodniy N.V., Karateev A.E., Alekseeva L.I., Chichasova N.V., Lazishvili G.D., Akhtyamov I.F., Bialik E.I., Makarov M.A., Taskina E.A., Schmidt E.I., Krylov V.V., Bialik V.E., Nesterenko V.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://mrj.ima-press.net/mrj/article/view/1447">https://mrj.ima-press.net/mrj/article/view/1447</self-uri><abstract><p>Локальная инъекционная терапия (ЛИТ)  – важная составляющая комплексного лечения болезней костно-мышечной системы (БКМС), широко используемая в реальной клинической практике. Для ЛИТ применяются глюкокортикоиды, препараты гиалуроновой кислоты (ГлК), аутологичные клеточные препараты, ботулинический токсин типа А, радиоактивные изотопы и др. ЛИТ позволяет добиться выраженного симптоматического эффекта, при этом в ряде случаев, например при проведении повторных курсов лечения ГлК у пациентов с остеоартритом, обсуждается возможность замедления прогрессирования заболевания и снижения потребности в хирургическом лечении.</p><p>Проведение ЛИТ требует специальной компетенции и навыков врача, тщательного соблюдения правил асептики и антисептики, инструментальной визуализации.  ЛИТ  может быть сопряжена с серьезными осложнениями, поэтому должна выполняться по строгим показаниям.</p><p>Совет экспертов был посвящен определению основных принципов ЛИТ. Были рассмотрены показания для применения тех или иных видов данной терапии,  доказательная база ее эффективности и безопасности, последовательность использования различных препаратов, а также необходимость комбинации ЛИТ с другими медикаментозными и немедикаментозными методами лечения БКМС.</p></abstract><trans-abstract xml:lang="en"><p>Local injection therapy (LIT)  is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT.  LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.</p><p>The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.</p><p>The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>локальная  инъекционная терапия</kwd><kwd>ревматические заболевания</kwd><kwd>глюкокортикоиды</kwd><kwd>гиалуроновая кислота</kwd><kwd>обогащенная тромбоцитами плазма</kwd><kwd>ботулинический токсин типа А</kwd><kwd>радиосиновэктомия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>local injection therapy</kwd><kwd>rheumatic diseases</kwd><kwd>glucocorticoids</kwd><kwd>hyaluronic acid</kwd><kwd>platelet-rich plasma</kwd><kwd>botulinum toxin type A</kwd><kwd>radiosynovectomy</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Совет экспертов  проведен при техническом  содействии  Rompharm Company.</funding-statement><funding-statement xml:lang="en">Expert advice was performed with the technical support of Rompharm Company.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Насонов ЕЛ, Яхно НН, Каратеев АЕ и др. 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