1
Q
Indications for Injections
A
osteoarthritis
RA
Gouty Arthritis
Synovitis
Bursitis
TEndonitis
Muscle trigger points
Carpal tunnel syndrome
(inflammation)
Wound anesthesia
2
Q
Steps of Injections
A
- clean/irrigate wound
- mark area for the injection (1cm superior and 1cm lateral to the superio-lateral aspect of patella)
- prep skin with betadine or alcohol
- analagesia (field/digital blocks) & into SubQ tissue (not into capsule b/c it will compromise fluid sampling)
- swab top of vials w/ alcohol before drawing into syringe
- change needles after drawing up solution in the syringe
- advance needle until you feel pop (capsule) (45degree angle)
- aspirate fluid before injecting
- grasp needle with hemostat while you twist off syringe and swap syringes
- inject steroid
- done.
3
Q
CI to joint injections?
A
Adjacent osteomyelitis
hemarthrosis
infectious arthritis
Periarticular cellulitis
poorly controlled DM
Clotting isorder and anticoagulation
Joint infection
immunosuppression
4
Q
Why might we add steroids to analgesia for injections?
A
some take effect quicker, others last longer.
5
Q
What is the best approach to a knee injection?
A
Best approach to knee injection is superoanterolateral.
