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Necrotising fasciitis is described as a complication of steroid injection of a painful shoulder in a previously well female. This case highlights a very rare life threatening emergency after steroid

Asthma is an important problem in the United Kingdom and a common presentation to accident and emergency (A&E) departments. In the majority of cases these patients are already using metered dose inhalers (MDI) as these allow a rapid, cost-effective, and safe method of delivering drugs directly to the lungs. In addition, they avoid many of the side effects associated with oral treatment. However, several surveys have shown that up to a quarter of patients using MDI have inadequate technique.'2 Recently, many alternative devices have been produced, particularly for young

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