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Therapeutic Injections of Joints and Soft Tissues

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Primer on the Rheumatic Diseases

Abstract

Therapeutic injections used in rheumatology include the articular, tenosynovial, and soft tissue injection of corticosteroids esters and the articular injection of hyaluronate and radioactive colloids. While the latter is controversial, corticosteroids and hyaluronate injections are in widespread use and will be discussed here.

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References

  1. Naredo E, Cabero F, Beneyto P, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol 2004;31:308–314.

    PubMed  Google Scholar 

  2. Murphy D, Failla JM, Koniuch MP. Steroid versus placebo injection for trigger finger. J Hand Surg [Am] 1995;20:628–631.

    Article  CAS  Google Scholar 

  3. Maneerit J, Sriworakun C, Budhraja N, et al. Trigger thumb: results of a prospective randomised study of percutaneous release with steroid injection versus steroid injection alone. J Hand Surg [Br] 2003;28:586–589.

    CAS  Google Scholar 

  4. Zingas C, Failla JM, Van Holsbeeck M. Injection accuracy and clinical relief of de Quervain’s tendinitis. J Hand Surg [Am] 1998;23:89–96.

    Article  CAS  Google Scholar 

  5. McCarty DJ, Marman JG, Grassanovich JL, et al. Treatment of rheumatoid joint inflammation with intrasynovial triamcinolone hexacetonide. J Rheumatol 1995;22:1631–1635.

    CAS  PubMed  Google Scholar 

  6. Rizzo M, Beckenbaugh RD. Treatment of mucous cysts of the fingers: review of 134 cases with minimum 2-year follow-up evaluation. J Hand Surg [Am] 2003;28:519–524.

    Article  Google Scholar 

  7. Meenagh GK, Patton J, Kynes C, et al. A randomised controlled trial of intra-articular corticosteroid injection of the carpometacarpal joint of the thumb in osteoarthritis. Ann Rheum Dis 2004;63:1260–1263.

    Article  CAS  PubMed  Google Scholar 

  8. Hui AC, Wong S, Leung CH, et al. A randomized controlled trial of surgery vs steroid injection for carpal tunnel syndrome. Neurology 2005;64:2074–2078.

    Article  CAS  PubMed  Google Scholar 

  9. Smith DL, McAfee JH, Lucas LM, et al. Treatment of nonseptic olecranon bursitis. A controlled, blinded prospective trial. Arch Intern Med 1989;149:2527–2530.

    Article  CAS  PubMed  Google Scholar 

  10. Smidt N, Lewis M, Hay EM, et al. A comparison of two primary care trials on tennis elbow: issues of external validity. Ann Rheum Dis 2005;64:1406–1409.

    Article  CAS  PubMed  Google Scholar 

  11. Stahl S, Kaufman T. The efficacy of an injection of steroids for medial epicondylitis. A prospective study of sixty elbows. J Bone Joint Surg Am 1997;79:1648–1652.

    CAS  PubMed  Google Scholar 

  12. Akgun K, Birtane M, Akarirmak U. Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome? Clin Rheum 2004;23:496–500.

    Article  Google Scholar 

  13. Carette S, Moffet H, Tardif J, et al. Intraarticular corticosteroids, supervised physiotherapy, or a combination of the two in the treatment of adhesive capsulitis of the shoulder: a placebo-controlled trial. Arthritis Rheum 2003;48:829–838.

    Article  CAS  PubMed  Google Scholar 

  14. Vecchio PC, Adebajo AO, Hazleman BL. Suprascapular nerve block for persistent rotator cuff lesions. J Rheumatol 1993;20:453–455.

    CAS  PubMed  Google Scholar 

  15. Jacob AK. Sallay PI. Therapeutic efficacy of corticosteroid injections in the acromioclavicular joint. Biomed Sci Instrum 1997;34:380–385.

    CAS  PubMed  Google Scholar 

  16. Carette S, Fehlings MG. Clinical practice. Cervical radiculopathy. N Engl J Med 2005;353:392–399.

    Article  CAS  PubMed  Google Scholar 

  17. Carette S, Leclaire R, Marcoux S, et al. Epidural corticosteroid injections for sciatica due to herniated nucleus pulposus. N Engl J Med 1997;336:1634–1640.

    Article  CAS  PubMed  Google Scholar 

  18. Carette S, Marcoux S, Truchon R, et al. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med 1991;325:1002–1007.

    Article  CAS  PubMed  Google Scholar 

  19. Zelle BA, Gruen GS, Brown S, et al. Sacroiliac joint dysfunction: evaluation and management. Clin J Pain 2005;21:446–455.

    Article  PubMed  Google Scholar 

  20. Kullenberg B, Runesson R, Tuvhag R, et al. Intraarticular corticosteroid injection: pain relief in osteoarthritis of the hip? J Rheumatol 2004;31:2265–2268.

    PubMed  Google Scholar 

  21. Godwin M, Dawes M. Intra-articular steroid injections for painful knees. Systematic review with meta-analysis. Can Fam Physician 2004;50:241–248.

    PubMed  Google Scholar 

  22. Weitoft T, Larsson A, Saxne T, et al. Changes of cartilage and bone markers after intra-articular glucocorticoid treatment with and without postinjection rest in patients with rheumatoid arthritis. Ann Rheum Dis 2005;64:1750–1753.

    Article  CAS  PubMed  Google Scholar 

  23. Calvo-Alén J, Rua-Figueroa I, Erausquin C. Treatment of anserine bursitis. Local corticosteroid injection vs. a NSAID. A prospective study. Rev Esp Reumatol 1993;20:13–15.

    Google Scholar 

  24. Canoso JJ, Wohlgethan JR, Newberg AH, et al. Aspiration of the retrocalcaneal bursa. Ann Rheum Dis 1984;43:308–312.

    Article  CAS  PubMed  Google Scholar 

  25. Genc H, Saracoglu M, Nacir B, et al. Long-term ultrasonographic follow-up of plantar fasciitis patients treated with steroid injection. Joint Bone Spine 2005;72:61–65.

    Article  PubMed  Google Scholar 

  26. Thomson CE, Gibson JN, Martin D. Interventions for the treatment of Morton’s neuroma. Cochrane Database Syst Rev 2004:CD003118.

    Google Scholar 

  27. Ching DW, Petrie JP, Klemp P, et al. Injection therapy of superficial rheumatoid nodules. Br J Rheumatol 1992;31:775–777.

    Article  CAS  PubMed  Google Scholar 

  28. Kamanli A, Kaya A, Ardicoglu O, et al. Comparison of lidocaine injection, botulinum toxin injection, and dry needling to trigger points in myofascial pain syndrome. Rheumatol Int 2005;25:604–611.

    Article  CAS  PubMed  Google Scholar 

  29. Eberhard BA, Sison MC, Gottlieb BS, et al. Comparison of the intraarticular effectiveness of triamcinolone hexacetonide and triamcinolone acetonide in treatment of juvenile rheumatoid arthritis. J Rheumatol 2004;31:2507–2512.

    CAS  PubMed  Google Scholar 

  30. Seror P, Pluvinage P, d’Andre FL, et al. Frequency of sepsis after local corticosteroid injection (an inquiry on 1160000 injections in rheumatological private practice in France). Rheumatology 1999;38:1272–1274.

    Article  CAS  PubMed  Google Scholar 

  31. Edwards PS, Lipp A, Holmes A. Preoperative skin antiseptics for preventing surgical wound infections after clean surgery [review]. Cochrane Database Syst Rev 2004:CD003949.

    Google Scholar 

  32. Yood RA. Use of gloves for rheumatology procedures. Arthritis Rheum 1993;36:575.

    Article  CAS  PubMed  Google Scholar 

  33. Weitoft T, Uddenfeldt P. Importance of synovial fluid aspiration when injecting intra-articular corticosteroids. Ann Rheum Dis 2000;59:233–235.

    Article  CAS  PubMed  Google Scholar 

  34. Thumboo J, O’Duffy JD. A prospective study of the safety of joint and soft tissue aspirations and injections in patients taking warfarin sodium. Arthritis Rheum 1998;41:736–739.

    Article  CAS  PubMed  Google Scholar 

  35. Chakravarty K, Pharoah PD, Scott DG. A randomized controlled study of post-injection rest following intra-articular steroid therapy for knee synovitis. Br J Rheumatol 1994;33:464–468.

    Article  CAS  PubMed  Google Scholar 

  36. Bellamy N, Campbell J, Robinson V. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2005:CD005321.

    Google Scholar 

  37. Caborn D, Rush J, Lanzer W, et al. Synvisc 901 Study Group. A randomized, single-blind comparison of the efficacy and tolerability of hylan G-F 20 and triamcinolone hexacetonide in patients with osteoarthritis of the knee. J Rheumatol 2004;31:333–343.

    CAS  PubMed  Google Scholar 

  38. Torrance GW, Raynauld JP, Walker V. Canadian Knee OA Study Group. A prospective, randomized, pragmatic, health outcomes trial evaluating the incorporation of hylan G-F 20 into the treatment paradigm for patients with knee osteoarthritis (part 2 of 2): economic results. Osteoarthr Cartil 2002;10:518–527.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. American British Cowdray Medical Center, Mexico City, Mexico

    Juan J. Canoso MD, FACP, MACR (Attending)

Authors
  1. Juan J. Canoso MD, FACP, MACR
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Editor information

Editors and Affiliations

  1. Arthritis Foundation, Atlanta, GA, USA

    John H. Klippel MD (President and CEO) (President and CEO)

  2. Massachusetts General Hospital, Boston, MA, USA

    John H. Stone MD, MPH (Associate Physician, Deputy Editor for Rheumatology) (Associate Physician, Deputy Editor for Rheumatology)

  3. Division of Rheumatology & Women’s Health, University of Kentucky, Lexington, KY, USA

    Leslie J. Crofford MD (Gloria W. Singletary Professor of Internal Medicine, Chief) (Gloria W. Singletary Professor of Internal Medicine, Chief)

  4. Arthritis Foundation, Atlanta, GA, USA

    Patience H. White MD, MA (Chief Public Health Officer) (Chief Public Health Officer)

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Canoso, J.J. (2008). Therapeutic Injections of Joints and Soft Tissues. In: Klippel, J.H., Stone, J.H., Crofford, L.J., White, P.H. (eds) Primer on the Rheumatic Diseases. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68566-3_40

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  • DOI: https://doi.org/10.1007/978-0-387-68566-3_40

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-35664-8

  • Online ISBN: 978-0-387-68566-3

  • eBook Packages: MedicineMedicine (R0)

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