Guide To Intra-Articular Injections
Guide to Intra-Articular InjectionsREGENERATIVE THERAPIESwww.CompanionRegenerativeTherapies.com - 1.877.627.3858
IntroductionDisclaimerThe purpose of this guide is to provide general guidelines and visual representation of proper intra-articular needle placement.This guide is not conclusive and administration of intra-articular products should only be done by licensed veterinarians.Indication For Use In DogsIntra-articular injections of biologic products (Platelet Rich Plasma and/ or Bone Marrow Derived Stem Cells) can be usefulin numerous indications for dogs, including: Use in the multimodal approach to combination therapy for OA in addition to rehabilitation therapy medicalmanagement For patients with residual post-operative intra-articular symptoms (effusion, discomfort, lameness) despite medicalmanagement and rehab For episodes of acute exacerbation of lameness and pain For patients intolerant or non-responsive to NSAIDs As a supplement or alternative to oral medical treatments For patients in which their OA has already progressed Post surgical lavage (synovial fluid replacement at time of surgery)Regenerative Therapy BenefitsStem Cells Platelet Rich PlasmaContribute to generating new tissueChemotactic for progenitor cellsSupply growth factorsMake extracellular nti-fibrotic Positive effects on angiogenesis andextracellular matrix remodelingStem cell recruitment and chemotaxisCell proliferation and differentiationPotent source of growth factors importantin regenerative processFibrin for matrix/ scaffoldClinical Application AlgorithmsCondition:Treatment Options/ Schedule:Mild Osteoarthritis and Synovitis1 PRP injection with 14 day follow-up to check improvement. If no improvement seen,administer 2nd PRP injection.Moderate Osteoarthritis1 PRP injection with 14 day follow-up to check improvement. If no improvement seen,administer 2nd PRP injection. Repeat if necessary or transition to PRP/Stem Cell.Severe OsteoarthritisPRP every other week (2-3 injections) or PRP/Stem Cell combination followed by boosterinjection in 9-12 months if needed.Acute Postoperative (8-12 weeks)Residual effusion/inflammation1 PRP injection with 14 day follow-up to check improvement. If no improvement seen,administer 2nd PRP injection.Ligament/Tendon Tear ( 50%)PRP/Stem Cell combination (not a high volume injection- do track marks under ultrasoundguidance)REGENERATIVE THERAPIES
Forelimb InjectionsShoulder InjectionsKey GuidelinesCommon Indications: Osteoarthritis, OCD, Medial Shoulder Syndrome, Bicep TenosynovitisRecommended Needle: 22 gauge, 1.5”Syringe for Aspirating Synovial Fluid: 5 or 6 mLLandmark for Blind Injection: Acromion ProcessInjection Volume GuidelinesSize of DogMiniature ( 10 lbs, ex: Yorkie, Toy Poodle)Small (10-25 lbs, ex: Sheltie, Boston Terrier)Medium (25-50 lbs, ex: Border Collie)Large (50-100 lbs, ex: Labrador Retriever)Giant ( 100 lbs, ex: Great Dane)Total Injection Volume (mL)½½-11-1 ½1 ½-22-3REGENERATIVE THERAPIES
Forelimb InjectionsElbow InjectionsKey GuidelinesCommon Indications: OsteoarthritisRecommended Needle: 22 gauge, 1.5”Syringe for Aspirating Synovial Fluid: 5 or 6 mLLandmark for Blind Injection: Medial Epicondyle ProcessInjection Volume GuidelinesSize of DogMiniature ( 10 lbs, ex: Yorkie, Toy Poodle)Small (10-25 lbs, ex: Sheltie, Boston Terrier)Medium (25-50 lbs, ex: Border Collie)Large (50-100 lbs, ex: Labrador Retriever)Giant ( 100 lbs, ex: Great Dane)Total Injection Volume (mL)¼- ½½-11-1 ½1 ½-22-2 ½REGENERATIVE THERAPIES
Forelimb InjectionsCarpal InjectionsKey GuidelinesCommon Indications: OsteoarthritisRecommended Needle: 22 gauge, 1.0”Syringe for Aspirating Synovial Fluid: 5 or 6 mLLandmark for Blind Injection: Antebrachial Carpal JointInjection Volume GuidelinesSize of DogMiniature ( 10 lbs, ex: Yorkie, Toy Poodle)Small (10-25 lbs, ex: Sheltie, Boston Terrier)Medium (25-50 lbs, ex: Border Collie)Large (50-100 lbs, ex: Labrador Retriever)Giant ( 100 lbs, ex: Great Dane)Total Injection Volume (mL) ¼¼ -½¼ -1¾ -11REGENERATIVE THERAPIES
Hind Limb InjectionsHip InjectionsKey GuidelinesCommon Indications: OsteoarthritisRecommended Needle: 22 gauge, 1.5” or 2.5-3” Spinal Needle for Larger BreedsSyringe for Aspirating Synovial Fluid: 5 or 6 mLLandmark for Blind Injection: Greater TrochanterTreatment Recommendation: Apply traction and external rotation to open joint space.Injection Volume GuidelinesSize of DogMiniature ( 10 lbs, ex: Yorkie, Toy Poodle)Small (10-25 lbs, ex: Sheltie, Boston Terrier)Medium (25-50 lbs, ex: Border Collie)Large (50-100 lbs, ex: Labrador Retriever)Giant ( 100 lbs, ex: Great Dane)Total Injection Volume (mL)½½-11-1 ½1 ½ -22-3REGENERATIVE THERAPIES
Hind Limb InjectionsStifle InjectionsKey GuidelinesCommon Indications: Osteoarthritis, Meniscal Injury, Early Partial TearsRecommended Needle: 22 gauge, 1.5”Syringe for Aspirating Synovial Fluid: 5 or 6 mLLandmark for Blind Injection: Patellar TendonTreatment Recommendation: Flex hock and stifle and apply abduct traction to open/alignjoint space. Insert needle perpendicular to joint to the right of the patellar tendon.Injection Volume GuidelinesSize of DogMiniature ( 10 lbs, ex: Yorkie, Toy Poodle)Small (10-25 lbs, ex: Sheltie, Boston Terrier)Medium (25-50 lbs, ex: Border Collie)Large (50-100 lbs, ex: Labrador Retriever)Giant ( 100 lbs, ex: Great Dane)Total Injection Volume (mL)½½-11-1 ½1 ½ -22-3REGENERATIVE THERAPIES
Hind Limb InjectionsHock InjectionsKey GuidelinesCommon Indications: OsteoarthritisRecommended Needle: 22 gauge, 1.0”Syringe for Aspirating Synovial Fluid: 5 or 6 mLLandmark for Blind Injection: Medial Compartment SpaceTreatment Recommendation: Put hock into deep flexion (do a range of motion). Insertneedle caudally at a 45 angle.Injection Volume GuidelinesSize of DogMiniature ( 10 lbs, ex: Yorkie, Toy Poodle)Small (10-25 lbs, ex: Sheltie, Boston Terrier)Medium (25-50 lbs, ex: Border Collie)Large (50-100 lbs, ex: Labrador Retriever)Giant ( 100 lbs, ex: Great Dane)Total Injection Volume (mL) ¼¼ -½¼-1¾-11REGENERATIVE THERAPIES
Forelimb Injections Elbow Injections Common Indications: Osteoarthritis Recommended Needle: 22 gauge, 1.5” Syringe for Aspirating Synovial Fluid: 5 or 6 mL Landmark for Blind Injection: Medial Epicondyle Process Key Guidelines Injection Volume Guidelines Size of Dog Total Injection Volume
Results Ultrasound Suboptimal injections - 3 patients with mixed intra- and extra-articular injections. - 2 patients with extra-articular injection. - 1 patient with no contrast injection due to patient discomfort. - 1 patient with inadequate visualization of the hip joint. 77 23 Ultrasound Guided Procedures Successful % Suboptimal %
However, few evidence-based guidelines for IM injections are available, and discrepancies within nursing textbooks have been noted. 10-13 In addition, current guidelines do not address administration of large-volume injections. The dorsogluteal site for IM injections is the one nurses have the most experience using, as this is what is tradi-File Size: 256KBPage Count: 6Explore furtherLarge-volume IM injections: A review of best practices .www.oncologynurseadvisor.comInjection Safety CDCwww.cdc.govGUIDELINES ON THE ADMINISTRATION OF INTRAMUSCULAR www.olchc.ieSECTION 20: PEDIATRICS: Medication: Intramuscular .www.vnhcsb.orgIntramuscular injection: Locations and administrationwww.medicalnewstoday.comRecommended to you b
The superior articular processes extend superiorly to meet the inferior articular processes of the T11 vertebra. Each superior articular process resembles those of the thoracic vertebrae, ending in a smooth, convex oval that corresponds with the concave oval of the inferior articular process of T11. The joints
make money Raise money for salaries or clinic by activities that do not harm patients nor waste medications. Outline: How to give injections safely Eliminate unnecessary injections Use sterile injection equipment and sharps Prepare and give injections without causing
Use of the ACOEM portions of this guideline beyond fair use or for commercial purpose, or both may only occur upon receipt of explicit permission from ACOEM. . D.6.d Tender and Trigger Point Injections.30 D.6.e Diagnostic Facet Joint Injections (Intra-articular and Nerve Blocks). 31 .
4 Intra-Articular The intra-articular or soft tissue administration of Kenalog-40 Injection is indicated as adjunctive therapy for sho
compared with plate fixation because of less interference with the soft tissue envelope [1]. Ligamentotaxis has several shortcomings, how-ever, when applied to the treatment of displaced intra-articular fractures of the distal radius. First, because ligaments exhibit viscoelastic behavio
2020 Manual for Railway Engineering (MRE) – Individual/Downloadable Chapters in PDF format. Visit www.arema.org Publication Title Member Price Non-Member Price S & H Fee Schedule Quantity Total Cost 2020 Manual for Railway Engineering (MRE) – Annual Publication released every April Complete Print Set 960 1,470 1
