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1

Winfield, J. Intra-articular injections using steroid and local anaesthetic. Audio Visual and Television Centre, University of Sheffield, 1988.

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2

Anderson, Bruce Carl. House officers guide to arthrocentesis and soft tissue injection. JJ&R Publishing, 1993.

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3

Anderson, Bruce Carl. House officers guide to arthrocentesis and soft tissue injection. 3rd ed. JJ & R Medical Publishing, 2001.

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4

A practical guide to joint & soft tissue injection & aspiration: An illustrated text for primary care providers. 2nd ed. Lippincott Williams & Wilkins, 2009.

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5

McNabb, James W. A practical guide to joint & soft tissue injection & aspiration: An illustrated text for primary care providers. 2nd ed. Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010.

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6

McNabb, James W. A practical guide to joint & soft tissue injection & aspiration: An illustrated text for primary care providers. 2nd ed. Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010.

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7

McNabb, James W. A practical guide to joint & soft tissue injection & aspiration: An illustrated text for primary care providers. 2nd ed. Lippincott Williams & Wilkins, 2009.

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8

V, Lawry George, and Kreder Hans J, eds. Musculoskeletal examination and joint injections techniques. Mosby, 2006.

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9

Moyer, William. Guide to equine joint injection. 2nd ed. Veterinary Learning Systems, 1993.

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10

Moyer, William. A guide to equine joint injection. Solvay Veterinary, 1986.

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11

Jürgen, Fischer. Atlas of injection therapy in pain management. Thieme, 2012.

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12

V, Lawry George, and Fam Adel G, eds. Fam's musculoskeletal examination and joint injection techniques. 2nd ed. Mosby, 2010.

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13

Pandey, Anil Kumar, and Sureshwar Pandey. Intra-Articular Injections. McGraw-Hill Professional, 2006.

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14

Pandey, Anil Kumar, and Sureshwar Pandey. Intra-Articular Injections. 2nd ed. McGraw-Hill Professional, 2006.

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15

Pandey, Sureshwar. Intra-Articular and Allied Injections. Jaypee Brothers Medical Publishers, 2017.

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16

Pandey, Sureshwar, and Anil Kumar Pandey. Intra-Articular and Allied Injections. Jaypee Brothers Medical Publishers, 2005.

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17

Pandey, Anil. Intra-articular and Allied Injections. Jaypee Brothers Medical Publishers (P) Ltd., 2005. http://dx.doi.org/10.5005/jp/books/10399.

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18

Vydyanathan, Amaresh, Karina Gritsenko, Samer N. Narouze, and Allan L. Brook. Cervical Intra-Articular Facet Injection: Computed Tomography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0009.

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Intra-articular facet joint injections commonly refer to the injection of a contrast media and local anesthetic solution, with or without corticosteroids, directly into the facet joint space. The purpose of this procedure is pain relief as well as to establish an etiological diagnosis for surgical interventions such as joint denervation or radiofrequency ablation. Medial branch block, or facet nerve block, refers to injection of local anesthetic and possible corticosteroids along the medial branch nerve supplying the facet joints. Cervical intra-articular and facet nerve block injections are o
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19

van Eerd, Maarten, Arno Lataster, and Maarten van Kleef. Cervical Facet Nerve Block and Radio Frequency Ablation: Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0007.

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In the cervical spinal column local anesthetic can be injected intra-articularly or adjacent to the ramus medialis (medial branch) of the ramus dorsalis of the segmental nerve. Nerve blocks of the ramus medialis are preferred to an intra-articular block, because it is sometimes technically difficult to position a needle into the facet joint. These procedures are typically performed under fluoroscopy, but there are increasing numbers of studies that describe these procedures with the help of ultrasound. Reports regarding the effects of intra-articular (steroid) injections are limited. There are
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20

McNabb, James W. A Practical Guide to Joint and Soft Tissue Injection and Aspiration. Lippincott Williams & Wilkins, 2004.

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21

Smith, Jay, and Jacob Sellon. Elbow Injections: Ultrasound. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0044.

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This chapter discusses sonographically guided elbow, tendon, and joint procedures used in the management of patients presenting with tendon and joint disorders of the elbow. Two sonographically guided corticosteroid injection techniques have been used for common extensor tendinosis, a superficial technique and a deep technique. Sonographically guided percutaneous longitudinal tenotomy has also been described for chronic flexor-pronator tendinosis. Distal biceps tendinopathy is a broad term that includes both inflammatory (tendinitis) and chronic degenerative (tendinosis) conditions. As the pro
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22

Souzdalnitski, Dmitri, Adam Kramer, and Maged Guirguis. Sacroiliac Joint Injections: Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0038.

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Sacroiliac joint (SIJ) injections are valuable tools for diagnosing the source of low back pain and selecting patients for a radiofrequency ablation procedure, which tends to provide long-term relief for low back pain associated with SIJ dysfunction. Sacroiliac joint injections are generally safe and well-tolerated procedures. The most common complication is initial pain from distension of the joint capsule with contrast and local anesthetic. Despite adequate intra-articular needle placement, extravasation of local anesthetic may diffuse to lumbosacral nerve roots and/or the sciatic nerve, cau
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23

Herman, Mira, Amaresh Vydyanathan, and Allan L. Brook. Sacroiliac Joint Injections: Computed Tomography. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0039.

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Sacroiliac (SI) joint disease is a common cause of low back pain. It is not easily diagnosed by physical examination, as the joint has limited mobility and referral patterns are not sufficiently delineated from other pathological conditions implicated in low back pain. The accuracy of provocative testing of the sacroiliac joint is controversial. Many physicians use injection of the SI joint with local anesthetic and/or steroid as a diagnostic and therapeutic tool in treating SI joint–related pain. Historically, SI joint intra-articular injections have been performed without imaging guidance. I
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24

Waldman, Steven D. Atlas of Pain Management Injection Techniques. 2nd ed. Saunders, 2007.

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25

Moyer, William. A Guide to Equine Joint Injection. Veterinary Learning Systems, 1997.

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26

Moyer, William. A Guide to Equine Joint Injection. 3rd ed. Veterinary Learning Systems, 2002.

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27

MD, James W. McNabb. A Practical Guide to Joint & Soft Tissue Injections. LWW, 2014.

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28

Foster, Helen, and Paul A. Brogan, eds. Specialized therapeutic approaches. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199592630.003.0008.

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Corticosteroid intra-articular injections 390Biologic therapies for paediatric rheumatological diseases 393Approvals for use of biologic therapies 399Medicines for children and paediatric rheumatology 401Haematopoietic stem cell transplantation 405(See also BSPAR guidelines for treatments used in paediatric rheumatology, p 415)Intra-articular corticosteroid injections are increasingly used as they allow rapid symptom control and allow time for other therapies, such as methotrexate (MTX) to have their effect. They often remove the need for the use of oral or IV corticosteroids and avoidance of
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29

Rheumatology Examination and Injection Techniques. W.B. Saunders Company, 1992.

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30

Perry, Julian David, Brian L. Hazleman, Charles W. Hutton, Peter J. Maddison, and Michael Doherty. Rheumatology Examination and Injection Techniques. 2nd ed. Saunders Ltd., 1999.

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31

Practical Procedures in Orthopaedic Surgery: Joint Aspiration/Injection, Bone Graft Harvesting and Lower Limb Amputations. Springer, 2011.

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32

Giannoudis, Peter V. Practical Procedures in Orthopaedic Surgery: Joint Aspiration/Injection, Bone Graft Harvesting and Lower Limb Amputations. Springer London, Limited, 2011.

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33

Arden, Nigel, and Terence O’Neill. Intra-articular injection therapy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0032.

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Intra-articular injection therapy is widely used in the management of osteoarthritis (OA). It has advantages over oral therapy in that it can provide targeted therapy to individual joint sites and at higher dose than could be achieved through oral administration and with fewer adverse effects. Intra-articular steroid therapy, the most widely used intra-articular therapy, is safe and effective in the short term particularly at the knee; though more studies are needed to better characterize the longer-term benefit. The role of intra-articular hyaluronic acid in clinical management of OA is less
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34

Foster, Brogan, and Paul A. Brogan. Specialized therapeutic approaches. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198738756.003.0008.

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This chapter provides updated guidance on specialized therapeutic approaches relevant to paediatric rheumatology. Detailed overviews include: intra-articular injections including guidance on triamcinolone hexacetonide and dose for paediatric joint injection; current indications and recommended doses for biologic therapies, including updated summaries of regulatory approvals for the use of these treatments; an overview of medicines commonly used in paediatric rheumatology, including a commentary on paediatric pharmacokinetics and specific safety issues; dose calculation in paediatric practice;
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35

Agarwal, Anil, Neil Borley, and Greg McLatchie. Orthopaedics. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199608911.003.0016.

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This chapter on orthopaedics outlines the application of a secondary cast to a forearm or leg manipulation under anaesthetic (MUA) of distal radius fracture plus minus insertion of Kirschner wires, intra-articular injections, joint aspirations, and diagnostic arthroscopy. Operations included are fixation of Weber B fracture of ankle, dynamic hip screw (DHS) for extra-capsular neck of femur fracture, fixation of patella fracture by tension band wiring, insertion of traction pins, surgical debridement of traumatic wound, fasciotomy for compartment syndrome of leg, carpal tunnel decompression, su
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36

Costandi, Shrif, Youssef Saweris, Michael Kot, and Nagy Mekhail. Thoracic Facet Nerve Block: Fluoroscopy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0015.

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The benefit of intra-articular local anaesthetic and steroid injections for the diagnosis and treatment of facet joint pain is controversial. Thoracic facet medial branch blocks are mainly used to confirm the diagnosis of thoracic facet arthropathy. Anatomic variability is blamed for failed treatments. Conventionally, thermal radiofrequency (RF) has been used to denervate thoracic facet joints. Cooled radiofrequency ablation (c-RFA) of the thoracic medial branch is emerging as a novel promising technique that provides relatively larger lesions that could compensate for the anatomic variation o
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37

Narouze, Samer N. Atlanto-Axial Joint Injection: Ultrasound. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0011.

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The atlanto-axial joint accounts for up to 16% of patients with occipital headache. Distending the lateral atlanto-axial joint with contrast agent produces occipital pain, and injection of local anesthetic into the joint relieves the headache. The clinical presentation of atlanto-axial joint pain is not specific and therefore cannot be used alone to establish the diagnosis. The only means of establishing a definite diagnosis is a diagnostic block with intra-articular injection of local anesthetic. Intra-articular steroids are effective in short-term relief of pain originating from the lateral
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38

Wenham, Claire Y. J., and Philip G. Conaghan. Osteoarthritis—management. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0140.

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Osteoarthritis (OA) is a common condition which often causes pain and functional limitation, significantly impacting on a person's quality of life. A comprehensive assessment of the impact of OA should be performed before selecting therapies and treatment goals. Current recommended therapies include a combination of pharmacological and non-pharmacological therapies, which should be considered for all people with OA, regardless of anatomical site of involvement. Non-pharmacological treatments include education, muscle strengthening and aerobic exercises, weight loss if appropriate, splints and
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39

Abhishek, Abhishek, and Michael Doherty. Treatment of calcium pyrophosphate deposition. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0052.

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The treatment of calcium pyrophosphate crystal deposition (CPPD) is mainly symptomatic. Acute calcium pyrophosphate (CPP) crystal synovitis should be treated with rest, local application of ice packs, joint aspiration, and/or intra-articular corticosteroid injection (once joint sepsis has been excluded). Oral colchicine or prednisolone may be used if joint aspiration and/or injection are not feasible. Anti-inflammatory agents (with proton pump inhibitors) may be used but in general these should be avoided as most patients with acute CPP crystal arthritis are elderly, and at a high risk of gast
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40

Zhang, Weiya, and Michael Doherty. Guidelines. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0037.

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A number of treatment guidelines have been developed to optimize the treatment of osteoarthritis, some of which were recently updated. Fifty-one non-pharmacological, pharmacological, and surgical treatments are addressed in these guidelines but only two (oral opioid and intra-articular steroid injection) reach the minimal clinically important difference above placebo. Recommendations for these treatments vary depending on joint sites, risk:benefit ratio, and population. Exercise, self-management, and weight reduction if obese are universally recommended. While topical non-steroidal anti-inflam
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