Intra articular steroid injection side effects

In common with other corticosteroids, triamcinolone is metabolised largely hepatically but also by the kidney and is excreted in urine. The main metabolic route is 6-beta-hydroxylation; no significant hydrolytic cleavage of the acetonide occurs. In view of the hepatic metabolism and renal excretion of triamcinolone acetonide, functional impairments of the liver or kidney may affect the pharmacokinetics of the drug. This may become clinically significant if large or frequent doses of intradermal or intra-articular triamcinolone acetonide are given.

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1cc of an aqueous suspension containing 25mg of methyl prednisolone acetate is used for injecting.  It is most important to inject into the lower joint compartment since this place the steroid in contact with damaged condyle.  The patient’s mouth is opened not more than 1cm by placing a suitable prop between the teeth.  The needle is advanced through the previous skin puncture angled slightly downwards and 45 o inwards and forwards to contact the posterosuperior surface of the condyle.  Gentle manipulation allows the needle to penetrate into the lower joint space and of the suspension is injected.  Lack of resistance confirms that the needle is in the joint space.  Where the upper space is also to be injected the needle is withdrawn to just below the skin and the patient’s mouth opened widely.  The needle is then passed upwards, inwards and forwards at approximately 45 o until the roof of the glenoid fossa is contacted.  After slight withdrawal of solution is deposited.  The needle is withdrawn and a small plaster placed over the skin puncture for a few hours.  Some increase in pain and stiffness in the injected joint may be experienced for 2 or 3 days and the patient should be warned of this and analgesics prescribed.  Discomfort should then steadily diminish.

Intra articular steroid injection side effects

intra articular steroid injection side effects

1cc of an aqueous suspension containing 25mg of methyl prednisolone acetate is used for injecting.  It is most important to inject into the lower joint compartment since this place the steroid in contact with damaged condyle.  The patient’s mouth is opened not more than 1cm by placing a suitable prop between the teeth.  The needle is advanced through the previous skin puncture angled slightly downwards and 45 o inwards and forwards to contact the posterosuperior surface of the condyle.  Gentle manipulation allows the needle to penetrate into the lower joint space and of the suspension is injected.  Lack of resistance confirms that the needle is in the joint space.  Where the upper space is also to be injected the needle is withdrawn to just below the skin and the patient’s mouth opened widely.  The needle is then passed upwards, inwards and forwards at approximately 45 o until the roof of the glenoid fossa is contacted.  After slight withdrawal of solution is deposited.  The needle is withdrawn and a small plaster placed over the skin puncture for a few hours.  Some increase in pain and stiffness in the injected joint may be experienced for 2 or 3 days and the patient should be warned of this and analgesics prescribed.  Discomfort should then steadily diminish.

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