Rheumatoid arthritis


For superolateral approach: Palpate superolateral and lateral edges of patella with patient supine and leg straight. If the patient cannot completely extend the knee, placement of a rolled towel to support the knee will help provide the patient comfort and minimize muscle spasm, improving the likelihood of a successful and comfortable injection. Clean and sterilize the injection site with chlorhexidine or betadine. If effusion is present, aspiration of the effusion can relieve patient discomfort, be of diagnostic benefit, and avoid dilution of a visco-supplement to be injected. If aspiration was required, the same needle can be used for aspiration and injection by changing the syringe. Insert needle (1 , 21-gauge for corticosteroids; 1 , 20- or 22-gauge for viscosupplementation) to 1 for injection. Remove needle, wipe off povidone iodine solution, and apply bandage.

Special Instructions

Side Effects And Complications

  • Patient should avoid strenuous activity for 1 to 2 days after injection and apply ice to injection site
  • Mild pain or swelling at the injection site can occur.
  • If mild pain or swelling occurs, recommend ice, nonsteroidal anti-inflammatory drug (NSAID), rest, and elevation