Joint Steroid Injection PRINT
Steroid Exposure Policy (Updated 08.31.2023)
Pre-Call Questions -Joint Injections & Arthrograms
a. Contrast -Isovue 300/ Omnipaque 240
b. 1% lidocaine (10ml’s)
c. 40mg/ml Depo Medrol (80mg/mL – Porter hospital only and bilateral joints = 40mg/mL each)
d. Sterile tray
i. Sterile Mayo Stand Cover
ii. Syringes – (2x(5mL)), (2x(10mL))
iii. Needles – (25G and 18G )1.5”, (22G 3.5”)
iv. Chlora Prep
v. Drapes- Tower drape x 2, Patient drape with hole
vi. 4×4 gauze
vii. Extension tubing
e. Sharpie and hemostat
f. 2” tape to move any excess tissue/ panniculus
g. Band-Aid
h. Mask
II. Personnel
a. Radiologist/RA
i. Reviews order (follows Steroid Exposure Policy (Updated 08.31.2023))
ii. Consents patient for injection (ask about Covid inj., dental visits, infection, antibiotics)
iii. Performs exam and evaluates patient’s pain level following injection
b. Hospital Technologist
i. PRINT ORDER- Call pt 1 day prior to exam: Pre-Call Questions -Joint Injections & Arthrograms
ii. Document patient history (dates of prior steroid injections) & pregnancy status prior to exam
iii. Assists the radiologist/RA during procedure & provides patient care
iv. Provides patient with aftercare instructions & dismisses patient after 20 minutes
III. Procedure
a. RA’s must review all INPATIENT joint injection requests with an MSK radiologist
i. Please review any pertinent prior imaging
ii. Please use the call center to connect with an available MSK rad (720-493-3777)
b. Consent (obtain pre-injection pain score)
c. Time out
d. Identify and mark the injection site using fluoroscopy (Mask)
e. Prepare the injection site using aseptic technique
f. Local anesthetic
g. Needle placement (do not aspirate)
i. If purulent fluid spontaneously flows back from the needle hub, aspirate, and cancel the steroid injection.
h. Inject 1-2mL’s Isovue/Omnipaque to confirm intraarticular needle placement (SAVE IMAGE)
i. Inject steroid/ lidocaine mix
j. Record pain score after 20 minutes
k. Reserve drafted dictation for the consulted MSK radiologist
IV. Required Images
a. Save image with contrast
V. Special Considerations
a. Follow contrast allergy protocol
b. Follow Pain Management Scheduling TIP SHEET EDUCATION (RE: COVID VACCINES see below)
c. Contraindications- Dental visit 3 days prior to injection, feeling ill or having a known infection, or currently on antibiotics (see Joint Injection/ Arthrogram Technologist Pre-Call Questions)
d. Bilateral lower extremity injections must have a driver
