Lateral knee steroid injection

This is one of the most unusual causes of lateral knee pain. It affects the joint between the top of the shin bone (tibia) and the fibular, the small, thin bone that runs down the outer side of the shin, just below the knee joint on the outer side. It takes a large force to dislocate the joint, . a car accident, but it can also partially dislocate (sublux) usually due to a fall when the foot  is plantarflexed (toes pointing down), which often also damages the tibiofibular ligament. Symptoms usually include lateral knee pain, instability especially during deep squats and sometimes an obvious deformity at the side of the knee. There may also be associated damage to the peroneal nerve leading to pins and needles or numbness around the outer knee. 

Testing essentially consists of one or two tests. The Tinel’s test has to do with the exquisite sensitivity of any nerve at an injury point. A nerve that is injured will fire an ectopic focus (a lightening bolt of electricity) down to the end of nerve when stimulated. Percussion of the injury area will elicit this “lightening bolt”. In the case of peroneal fibular head entrapment syndrome, the injury point is where the nerve wraps around the fibula. A positive test will cause an electrical “zap” into the foot with percussion of the peroneal nerve at this location.

Steroid injections are commonly used to treat rotator cuff tendinopathy, but controlled studies have demonstrated modest benefit, particularly in the long term. 34 Steroid injections should be reserved for patients who have discomfort that would limit them from engaging in rehabilitative exercises. Injections into the gluteal muscle versus guided injections into the subacromial bursa have demonstrated similar levels of pain relief. 35 Surgical options are available for patients with persistent symptoms, or for patients in whom function cannot be maintained.

Following aspiration of the prepatellar bursa, a pressure dressing should be applied, and the patient should remain in the supine position for several minutes. Following injection, the joint or injected region may be put through passive range of motion. The patient should remain in the office for 30 minutes after the injection to monitor for any adverse reactions. In general, patients should avoid strenuous activity involving the injected region for several days. Patients should be cautioned that they may experience worsening symptoms during the first 24 to 48 hours related to a possible steroid flare, which can be treated with ice and nonsteroidal anti-inflammatory drugs. Patients should be instructed against the application of heat. A follow-up appointment should be scheduled within three weeks.

Lateral knee steroid injection

lateral knee steroid injection

Following aspiration of the prepatellar bursa, a pressure dressing should be applied, and the patient should remain in the supine position for several minutes. Following injection, the joint or injected region may be put through passive range of motion. The patient should remain in the office for 30 minutes after the injection to monitor for any adverse reactions. In general, patients should avoid strenuous activity involving the injected region for several days. Patients should be cautioned that they may experience worsening symptoms during the first 24 to 48 hours related to a possible steroid flare, which can be treated with ice and nonsteroidal anti-inflammatory drugs. Patients should be instructed against the application of heat. A follow-up appointment should be scheduled within three weeks.

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