What is the role of intrabursal corticosteroid injections in the treatment of bursitis?

Updated: Dec 11, 2020
  • Author: Kristine M Lohr, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Corticosteroid injections can be helpful if the patient does not respond to other treatment within 7-14 days. Various steroids (eg, hydrocortisone, prednisolone, methylprednisolone, triamcinolone, betamethasone, and dexamethasone) have been used in this setting, but no single agent has been found to be demonstrably superior. Steroids can be mixed in the same syringe with lidocaine or bupivacaine.

Corticosteroid injections can be performed either in the emergency department (ED) or in an outpatient setting. [33, 34] A 1.5- to 4-inch 20-gauge spinal needle may be used as a probe to determine the points of maximal tenderness in the affected bursa. Typically, a mix of corticosteroid and local anesthetic is injected into each tender site. The corticosteroid dose should be 20 mg or less per lesion, and no more than a total of 40 mg of corticosteroid should be used. [10, 14, 35]

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