What is an Intra-articular infiltration or Injection?

SHOUDER

An intra-articular infiltration or injectionis a form of treatment that involves injecting powerful anti-inflammatory corticosteroids and analgesic into a joint under Fluoroscopy Guided-Image Technology . This type of injection is routinely performed on patients suffering from a variety of conditions that cause inflammation in the joints of the body. Intraarticular steroid injections have been used on patients since 1951. Since then, they have been the subject of numerous medical studies that have revealed their benefits in treating pain and inflammation.

  • Approximately 7.5 million people go to the doctor’s office every year for shoulder injuries, including shoulder and upper arm sprains and strains. 
  • About 2/3 of patients with shoulder pain don’t need surgery. Conservative treatment options like rotator cuff exercises and Infiltration under fluoroscopy guided image  technology reduce shoulder inflammation and improve functionality.
  • Shoulder pain can make activities such as throwing a ball, lifting a heavy dish from a high cupboard, or even steering a car difficult. The shoulder is engaged in almost all arm movements, so painful movement of the shoulder joint affects many everyday activities.

Intraarticular steroid injections are often considered when oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, naproxen, and the analgesic acetaminophen (Tylenol) are not effective to control pain and inflammation.  Intraarticular steroid injections decrease inflammation by lowering the number of lymphocytes, mast cells, macrophages, and inflammatory mediators. Intraarticular steroid injections can be performed on the hips, knees, shoulders, hands, and other inflamed joints of the body. The primary goals of these injections are to alleviate pain, reduce inflammation, and help increase mobility in the affected joint.

How is a Intraarticular Steroid Injection Performed?

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Prior to an intraarticular steroid injection procedure, the patient’s skin is sterilized at the site of the injection. A fluoroscopic injection of contrast (dye) is injected and observed on a monitor to help confirm accurate placement of the steroid medication. The pain management physician then injects a combination of local anesthetic and steroid medication into the inflamed joint. Depending on the location of the injection, the entire procedure takes approximately 5 to 15 minutes.
There are several types of steroids available, which have different durations and effects. Solubility is the mitigating factor that determines the duration and effectiveness of the steroid. Insoluble steroids are typically preferred because their effect lasts longer.
Current medical literature supports the role of intraarticular steroid injections for the treatment of inflammation and joint pain associated with osteoarthritis. Additional studies have also shown positive treatment outcomes for rheumatoid arthritis.
One significant double-blind, placebo-controlled study published in Arthritis & Rheumatism, sampled 52 patients with osteoarthritis-related pain in the hip. The patients were randomized to intraarticular steroid injection (some received intraarticular steroid injections, while others received a placebo). The results of the study revealed that the treatment group had considerable pain relief from the injection after a three month follow-up without any major side effects.
Intraarticular injections are considered a safe, non-invasive procedure; however, as with all procedures, there is some risk of complications. Although rare, risks include bleeding, nerve damage, infection, and tendon damage.

Conditions Related To Intraarticular Steroid Injection

As we age, our joints begin to suffer from normal mechanical wear and tear. Trauma, overweight, diabetis or hereditary conditions may also accelerated the process. Intraarticular steroid injections are used to treat one of the hallmark conditions of joint degeneration, known as osteoarthritis. This degenerative disease involves the breakdown of cartilage that cushions and protects the joints and is one of the most common disabling conditions in the United States.  Car accidents,  falls, or any traumatic event,  may cause a hard blow that damages the articular cartilage and joint bleeding, leading to joint pain and degenerative traumatic arthritis . Injuries from sports activities like soccer, baseball, gymnastics, hockey, or lacrosse often cause degenerative arthritis.
Screenshot 69Current statistics have revealed that approximately 30% of people older than 50 years of age have signs of osteoporosis, and over 80% of people older than 65 years of age show evidence of the disease. Osteoarthritis commonly affects the hips, spine, knees, shoulders, fingers, toes, and feet; however, other joints can be implicated as well. Intraarticular steroid injections can also be helpful in treating inflammatory joint conditions such as gout, psoriatic arthritis, rheumatoid arthritis, and tendonitis.
Arthritis
Joint Arthritis is painful inflammation and stiffness of the joints, which can be caused by many types of degenerative joint conditions. There are over 100 types of arthritis, including osteoarthritis, rheumatoid, gout, psoriatic, septic, post-traumatic, and lupus. Arthritis symptoms can include swelling, tenderness, sharp pain, stiffness, and sometimes fever and chills.
Traumatic Arthritis 
Car accidents,  falls, or any traumatic event,  may cause a hard blow that damages the articular cartilage and joint bleeding leading to joint pain and degenerative traumatic arthritis . Injuries from sports activities like soccer, beisball, gymnastics, hockey, or lacrosse often cause degenerative arthritis.
Bursitis
Bursitis is painful inflammation of the bursae, the fluid-filled sacs that reduce friction between bones, tendons, and muscles. Bursitis in the shoulder is commonly caused by an injury, infection or other condition. Pain may be accompanied by swelling, tenderness or loss of movement.

 

Conclusion

 Intra-articular/Joint Injections or infiltrations under Fluoroscopy Guided-Image Technology are a non-invasive option for treating a variety of chronic, painful conditions. This nonsurgical treatment has been the subject of numerous studies, and is largely regarded as a safe and effective treatment option for joint inflammation and pain.

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