Steroid Dosage for Pes Anserine Bursa Injection
For pes anserine bursa injection, the recommended dose of triamcinolone acetonide is 20-40 mg (5-10 mg/mL concentration). 1, 2
Dosing Recommendations
- Triamcinolone acetonide at a concentration of 5-10 mg/mL is the commonly used steroid preparation for pes anserine bursa injections 3, 1
- The total dose typically ranges from 20-40 mg, depending on the size of the affected area 2
- A volume of 0.05-0.1 mL per injection site is sufficient to produce therapeutic effect in the target area 3
- Multiple small injections may be administered within the bursa, with the total volume not typically exceeding 2-4 mL 2
Administration Technique
- Ultrasound guidance significantly improves the accuracy and efficacy of pes anserine bursa injections compared to blind injection technique 4
- In ultrasound-guided studies, patients receiving accurately placed injections showed significantly better pain relief at both 1 week and 4 weeks post-injection 4
- The injection should be administered just beneath the dermis in the upper subcutis of the pes anserine area 3
- Strict aseptic technique is mandatory for all steroid injections to prevent infection 2
Clinical Considerations
- Pes anserine bursitis often responds well to local corticosteroid injection, particularly when associated with knee osteoarthritis 5, 6
- Patients with ultrasound-confirmed pes anserine bursitis show better response to corticosteroid injection than those with clinical diagnosis alone 7
- Corticosteroid injection has been shown to be as effective as physical therapy for pes anserine tendino-bursitis, but provides faster relief 6
- Local injection therapy is considered an effective, inexpensive, and rapid therapeutic method for pes anserine bursitis 6
Potential Adverse Effects
- Skin atrophy at the injection site is a potential side effect of intralesional corticosteroid therapy, particularly with triamcinolone 3
- Other possible local adverse effects include skin discoloration, telangiectasia, and folliculitis 1
- Care should be taken to avoid injecting into the tendon substance rather than the bursa 2
- The minimum effective dose should be used to minimize potential side effects 1
Follow-up Considerations
- Most patients experience significant improvement in pain and function within 1-4 weeks after injection 4, 7
- A single injection is often sufficient, but some patients may require repeated injections for adequate symptom relief 2
- If symptoms persist despite accurate injection, consider alternative diagnoses or additional treatment modalities 6