Dosing for intra-articular corticosteroids depends on the size of the joint and severity of the condition.
Dosing guide in the Depo-Medrone Summary of Product Characteristics:
(metacarpophalangeal, interphalangeal, sternoclavicular, acromioclavicular):
|Medium joint||(elbow, wrist):
• (10-40mg of steroid)
|Large joint||(knee, ankle, shoulder):
• (20-80mg of steroid)
Repeated injections, if needed, may be given at intervals of one to five (or more) weeks, depending upon the degree of relief obtained from the initial injection.1,2
Concerns have been raised that repeated intra-articular corticosteroid injections cause progressive cartilage damage and consequently it has been suggested that injection should not be given in a single joint at more than three-monthly intervals, nor should there be more than two or three injections per joint per year.3
However, studies have shown the knee joint in OA patients who received multiple intra-articular injections of steroids showed no significant evidence of destruction or accelerated deterioration.4
Local anaesthetic may be co-administered with intra-articular corticosteroids4
Preparations including lidocaine together with methylprednisolone are available (Intra-articular Depo-Medrone with Lidocaine)2
- Pfizer Limited. Depo-Medrone Summary of Product Characteristics.
- Pfizer Limited. Depo-Medrone with Lidocaine Summary of Product Characteristics.
- Bellamy N, et al. Cochrane Database Systematic Rev. 2006; Apr 19(2): CD005328. DOI: 10.1002/14651858.CD005328.pub2.
- Neustadt DH. Cleve Clin J Med 2006; 73(10): 897-911