Table Of ContentMusculoskeletal
Injections and
Alternative Options
A practical guide to
‘what, when, and how?’
Musculoskeletal
Injections and
Alternative Options
A practical guide to
‘what, when, and how?’
Edited by
Maneesh Bhatia
Consultant Orthopaedic Foot and Ankle Surgeon
University Hospitals of Leicester, UK
Video Editor
Kethesparan Paramesparan
CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742
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Library of Congress Cataloging-in-Publication Data
Names: Bhatia, Maneesh, editor.
Title: Musculoskeletal injections and alternative options :
a practical guide to ‘what, when and how?’ / [edited by] Maneesh Bhatia.
Description: Boca Raton : CRC Press, [2019] | Includes bibliographical references and index.
Identifiers: LCCN 2018060148| ISBN 9780815355540 (paperback : alk. paper) | ISBN
9780815355571 (hardback : alk. paper)
Subjects: | MESH: Musculoskeletal Pain--drug therapy | Injections--methods |
Nerve Block--methods | Treatment Outcome
Classification: LCC RM170 | NLM WE 140 | DDC 615/.6--dc23
LC record available at https://lccn.loc.gov/2018060148
Visit the Taylor & Francis Web site at
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I would like to dedicate this book to my dearest wife, Sulaxni, and my
adorable kids, Yash and Juhi, for their endless love and support.
Contents
List of videos xiii
e-Resources xv
Foreword by Nicola Maffulli xvii
Foreword by Bill Ribbans xix
Review and endorsements xxi
Editor xxiii
Editor’s Note xxv
Contributors xxvii
1 Musculoskeletal injections in general 1
Devendra Mahadevan and Euan Stirling
Introduction 1
What are corticosteroids? 1
How do steroid injections work? 2
What are the indications and contraindications of
corticosteroid injections? 2
What is the evidence for the use of corticosteroid
injections for musculoskeletal pain? 4
What are examples of injectable corticosteroid agents? 7
How do you select an appropriate corticosteroid
preparation for a specific joint or soft tissue injection? 8
Should corticosteroids be combined with local
anaesthetics when giving injections? 8
Which local anaesthetic agents are appropriate to use
with corticosteroid? 9
What equipment is needed for corticosteroid injection? 9
Which joints can be injected without image guidance? 11
How often can you inject a joint? 12
Should corticosteroids be used around tendons? 13
vii
viii Contents
Do all patients respond to corticosteroid injections? 13
What are the potential side effects and complications of
corticosteroid injections? 14
What adjuncts are available for steroid injection? 15
What are the alternatives to steroid injection? 16
References 18
2 Shoulder and elbow injections 23
Helen Tunnicliffe and Harvinder Pal Singh
Introduction 23
How to differentiate shoulder pain? 24
What is the role of physiotherapy in shoulder
disorders? 25
What is the role of steroid injections for shoulder disorders? 26
Osteoarthritis 27
Impingement/subacromial bursitis/tendinopathy 27
Frozen shoulder/joint stiffness 30
Degenerative rotator cuff tears 30
Calcific tendinitis 31
Diagnostic injection 31
What are the contraindications for injection of
the shoulder? 32
What are the risks? 33
Which drugs to use? 33
How to inject the glenohumeral joint? 34
Anterior approach to the glenohumeral joint? 36
How to inject the acromioclavicular joint? 37
How to inject the subacromial space? 38
How to inject the elbow joint? 40
How to inject for tennis elbow? 40
How to inject for golfer’s elbow? 42
References 44
3 Hand and wrist injections 47
Sunil Garg
Introduction 47
Carpal tunnel syndrome 47
De Quervain’s tenosynovitis 52
First carpometacarpal joint osteoarthritis 54
Contents ix
Trigger finger 57
References 60
4 Hip and knee injections 63
Ashwin Kulkarni and Kimberly Lammin
Introduction 63
Injections around the hip joint 63
What are the indications and contraindications for
lateral soft tissue hip injection? 65
How to prepare and what is the technique for GTPS
injection? 66
What are the injection contents? 68
What is the efficacy of injections for GTPS? 69
What are the treatment options for GTPS? 69
Intra-articular hip injections: Introduction 70
What are the indications and contraindications for
intra-articular hip injections in adults? 71
Preparation and technique for intra-articular hip
injection (in adults) 72
What is the efficacy of hip injections? 74
Injections around the knee joint: Introduction 74
What are the indications and contraindications for
intra-articular knee joint injection? 75
Preparations and technique for knee injection 76
Suprapatellar approach 77
Approaches adjacent to the patellar tendon 78
What are the knee injection contents? 80
What is the efficacy of knee injections? 80
What are various treatment options for osteoarthritis of
the knee? 80
What are the potential complications and risks of all
injections around and into the hip and knee? 81
References 83
5 Foot and ankle injections 85
Bobby Mobbassar Siddiqui, Annette Jones,
and Maneesh Bhatia
Introduction 85
What are the important anatomical considerations? 86
What are the techniques of injection? 90
