By Lyn D Weiss MD, Julie K. Silver MD, Ted A. Lennard MD, Jay M. Weiss MD

This sensible, special guide courses you step-by-step in the course of the most typical injection concepts for a whole diversity of issues. specialists within the box assist you verify no matter if an injection is indicated, localize the location, decide upon the right kind needle, stay away from attainable issues, supply priceless post-injection care, and extra. A uncomplicated layout, scientific pearls, state of the art line drawings, and the newest instructions make this instruction manual a necessary reference for any surgeon appearing an injection process.

  • A uniform layout publications you thru each step of the most typical injection recommendations, from treating musculoskeletal and neurologic problems to acting replacement methods akin to acupuncture.
  • Recommendations for the simplest variety of injections, in addition to what drugs and what sort of to inject, assist you not sleep to this point and supply state of the art care.
  • Extensive insurance of universal rules particular to every injection zone is helping you triumph over even your hardest instances.
  • Clinical pearls in every one bankruptcy offer quick access to key options and methods.
  • Detailed line drawings highlighting significant landmarks paired with photos offer shiny, visible advice for actual needle placement.
  • A convenient, moveable measurement makes need-to-know details available at any time.

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May have a tender nodule that is palpable. May complain of swelling and/or stiffness in the fingers. Pain worse with activities that require gripping. More common in patients with diabetes or rheumatoid arthritis. May require external force to straighten the finger. Physical Examination Findings l Triggering of the finger. l May have a tender nodule that is palpable. 58 4 Tendons l May have decreased range of motion of the finger caused by pain or contractures. l With the metacarpal phalangeal joint flexed, the joint may be flexed passively ­without pain.

Tendinitis may coexist and may require additional treatment. Postinjection Care Apply a sterile dressing and pressure over the injection site. Have the patient ice the affected area for 20 minutes two to three times daily for the first 24–48 hours. Then begin local heat and gentle stretching exercises several days after the injection. When to Perform Follow-Up Injections Although there are no strict guidelines, a reasonable approach is to reinject in 4–6 weeks if symptoms persist or return. Partial relief of symptoms is an indication for a repeat injection.

Medications to Inject A corticosteroid and local anesthetic mixture is injected. Some physicians prefer injecting hyaluronic acid. Amount to Inject The injectate amount is 5–8 cc. 43 44 Easy Injections Size and Gauge of Needle A 1½–2-inch 21-gauge needle is used. ) The length of the needle will depend on how much subcutaneous tissue is in the affected area. People who have more adipose tissue will require the use of a longer ­needle. Local Anatomy The knee joint is composed of the tibiofemoral joint (located between the tibia and the femur) and the patellofemoral joint (located between the patella and the femur).

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