What is the recommended dose of triamcinolone acetonide (steroid) for a hip bursitis injection?

Recommended Triamcinolone Acetonide Dosage for Hip Bursitis Injection

For hip bursitis injection, the recommended dose of triamcinolone acetonide is 40 mg. 1

Dosage Guidelines

The FDA-approved triamcinolone acetonide dosing for intra-articular injections provides clear guidance:

• For larger joints (including the hip): 5-15 mg is the initial recommended dose 1
• However, for adults, doses up to 40 mg for larger areas are typically sufficient 1

The hip trochanteric bursa is considered a larger joint area, and clinical evidence supports using the higher end of the dosing range for optimal therapeutic effect.

Injection Technique

When administering triamcinolone for hip bursitis:

1. Use strict aseptic technique (mandatory) 2, 1
2. Shake the vial before use to ensure uniform suspension 1
3. Inspect for clumping or granular appearance (discard if present) 1
4. Consider using ultrasound guidance for accurate placement 2
5. Consider local anesthetic for patient comfort (can be mixed with the injectate) 2

Clinical Evidence Supporting This Dose

Clinical research specifically examining trochanteric bursitis has demonstrated excellent outcomes with corticosteroid injections:

• In a study of 36 cases of trochanteric bursitis, one or two local corticosteroid injections provided excellent response in two-thirds of patients and improvement in the remaining cases 3
• Another study found that 15 patients with rheumatoid arthritis and trochanteric bursitis responded well to local corticosteroid injections 4

Important Considerations and Precautions

• Contraindications: Do not inject at sites of active infection, in patients with hypersensitivity to triamcinolone, or in those with active tuberculosis or systemic fungal infections 5
• Comorbidities: Use with caution in patients with uncontrolled diabetes, heart failure, or severe hypertension 5
• Potential adverse effects: Local overdose can result in skin atrophy, pigmentary changes, and telangiectasias 5
• Timing considerations: Avoid corticosteroid injections for 3 months preceding joint replacement surgery 2
• Monitoring: Patients with diabetes should be monitored for transient hyperglycemia during days 1-3 post-injection 2

Follow-up Recommendations

• Most patients experience significant improvement within 48-72 hours after injection
• Benefits typically last several weeks to months
• If symptoms recur, a second injection may be considered, but repeated injections should be approached cautiously due to potential long-term negative effects on bone health and joint structure 2
• If inadequate response after 1-2 injections, consider alternative diagnoses or treatment approaches

By following these evidence-based guidelines for triamcinolone acetonide dosing in hip bursitis, you can optimize pain relief while minimizing potential adverse effects.