Intra articular steroid injection-ankle

An assessment of viscosupplementation for knee OA by the Canadian Agency for Drugs and Technologies in Health (CADTH) (Dagenais, 2006) found that evidence suggests modest short-term reductions in pain and improvements in function, and no superiority among viscosupplement products.  Adverse events are rare, benign, temporary, and likely associated with the intra-articular injection.  The assessment reported that clinical practice guidelines and evidence suggest that this approach is most suitable for patients with mild to moderate knee OA, and in those for whom other approaches are contraindicated, or have failed.

Kenalog in blood - Derby et al. "Size and aggregation of corticosteroids used for epidural injections"

  • Depo-Medrol also formed large aggregations in the study by Tiso et al [6]
  • Celestone Soluspan formed large aggregations only in the Derby et al study  [7 ]
  • It is speculated that these large aggregates occlude smaller vessels, and thus lead to infarction .
  • Injection of methylprednisolone vs dexamethasone vs prednisolone into the vertebral artery of pigs – see summary of study here

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    MAIN OUTCOME MEASUREMENTS:Perceived improvement in symptoms at least 6 months after treatment, perceived change in visual analog scale score, assessment of functional pain, and overall satisfaction.
    RESULTS:
    On average, patients were 48 years old, had symptoms for a median of 18 months before treatment, and answered the survey on average 15 months after treatment. Overall, 82% of patients indicated moderate to complete improvement in symptoms. The most common injection sites were the lateral epicondyle, Achilles, and patellar tendons. Other sites treated included the rotator cuff, hamstring, gluteus medius, and medial epicondyle, among others. Furthermore, 60% of patients received only 1 injection, 30% received 2 injections, and 10% received 3 or more injections. Patients' perceived decrease in visual analog scale score was 75%, from ± to ± (-, SD , 95% confidence interval - to -, P < .0001). In addition, at follow-up, 95% of patients reported having no pain at rest that disrupted their activities of daily living and 68% reported no pain during activities. A total of 85% of patients were satisfied with the procedure.
    ​CONCLUSIONS:
    In this retrospective study, in which we evaluated administration of PRP for chronic tendinopathy, we found that the majority of patients reported a moderate (>50%) improvement in pain symptoms.

    Intra articular steroid injection-ankle

    intra articular steroid injection-ankle

    MAIN OUTCOME MEASUREMENTS:Perceived improvement in symptoms at least 6 months after treatment, perceived change in visual analog scale score, assessment of functional pain, and overall satisfaction.
    RESULTS:
    On average, patients were 48 years old, had symptoms for a median of 18 months before treatment, and answered the survey on average 15 months after treatment. Overall, 82% of patients indicated moderate to complete improvement in symptoms. The most common injection sites were the lateral epicondyle, Achilles, and patellar tendons. Other sites treated included the rotator cuff, hamstring, gluteus medius, and medial epicondyle, among others. Furthermore, 60% of patients received only 1 injection, 30% received 2 injections, and 10% received 3 or more injections. Patients' perceived decrease in visual analog scale score was 75%, from ± to ± (-, SD , 95% confidence interval - to -, P < .0001). In addition, at follow-up, 95% of patients reported having no pain at rest that disrupted their activities of daily living and 68% reported no pain during activities. A total of 85% of patients were satisfied with the procedure.
    ​CONCLUSIONS:
    In this retrospective study, in which we evaluated administration of PRP for chronic tendinopathy, we found that the majority of patients reported a moderate (>50%) improvement in pain symptoms.

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