title: Intra-articular, bursa, and tendon sheath injections: a survey of practice patterns among members of the American College of Rheumatology.
abstract: OBJECTIVE
  The objective of this study was to survey members of the American College of Rheumatology (ACR) regarding intra-articular and soft tissue (musculoskeletal [MSK]) injections and to determine if injection techniques vary depending on type of practice and years of experience.
  
  
  METHODS
  A survey was e-mailed to the members of the ACR to obtain demographics of the respondents, MSK injection practices, and adverse events seen.
  
  
  RESULTS
  The most common indications for MSK injections were rheumatoid arthritis, osteoarthritis, and bursitis. Written consent and time-out procedures were more common in academic/government practices when compared with private practice. There was variation in the type of corticosteroid used. The most common preparations were methylprednisolone actetate (45.0%), triamcinolone acetonide (26.1%), triamcinolone hexacetonide (22.1%). This survey showed good agreement on the dosage of corticosteroid for MSK injections; however, as years of experience increased, clinicians were more likely to prescribe lower doses for shoulder and knee injections.
  
  
  CONCLUSIONS
  In this survey of ACR members, we found self-reported differences in the type of corticosteroid used for MSK injections. There was general agreement on frequency of injections, but more experienced practitioners reported using lower doses of corticosteroid.
authors.affiliation: From the *VA-New York Harbor Healthcare System; †SUNY Downstate Medical Center; and ‡Long Island College Hospital, Brooklyn, NY.
authors.forename: Deana
authors.initials: D
authors.lastname: Lazaro
authors.forename: Leah
authors.initials: L
authors.lastname: Alon
authors.forename: Nina
authors.initials: N
authors.lastname: Ramessar
authors.forename: Jenny
authors.initials: J
authors.lastname: Cabas-Vargas
authors.forename: Kyawt
authors.initials: K
authors.lastname: Shwin
authors.forename: Dimitre G
authors.initials: DG
authors.lastname: Stefanov
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002061:Bursa, Synovial; D002062:Bursitis / Q000188:drug therapy*; D003625:Data Collection; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007267:Injections / Q000379:methods; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D057566:Self Report; D012955:Societies, Medical; D013710:Tendons; D014481:United States
chemical_list: D005938:Glucocorticoids