What to Inject in Painful Hand Joints?

A review of 28 studies found 10 -20 mg injected in small joints with Triamcinolone the superior product.

PM R. 2018 Oct 6. pii: S1934-1482(18)30981-X. doi: 10.1016/j.pmrj.2018.09.040.
[Epub ahead of print]
The Effectiveness of Injected Corticosteroid Type, Dose, and Volume for the Treatment of Pain in Small- and Intermediate-size Joints: A Systematic Review.
Cushman DM et al
https://www.ncbi.nlm.nih.gov/pubmed/30300767

Best results have been found with injecting dorsally:

(example with methylene blue on cadavers)

injecthand_dorsal

Pichler, W., et al.
Frequency of successful intra-articular puncture of finger joints: influence of puncture position and physician experience.
Rheumatology 47.10 (2008): 1503-1505.
https://academic.oup.com/rheumatology/article/47/10/1503/1786768

resident/specialist – 83% success dorsally; 73% dorso-radial

Comment – not that much difference either way… If you really need intraarticular, maybe give half each way..

 

 

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