Peripheral Joint Injections.

Peripheral joint injections are a common interventional treatment of peripheral joint-mediated pain, including arthritis, tendinopathy, and bursitis that are not responsive to conservative management. Degenerative changes of articular joints are often related to these symptoms through chronic inflammatory changes, which typically arise due to repetitive trauma, autoimmune disease, or metabolic abnormalities. The primary diagnosis for degenerative disease in the peripheral joints is osteoarthritis but can also include rheumatoid arthritis, gout, and other less common etiologies. Chronic inflammatory damage to the articular surfaces and joint capsules can lead to pain and functional decline. As such, the use of peripheral joint injections after the failure of typical conservative treatment, including physical therapy and oral medications, is common. Although these injections are typically not curative in nature, their primary objective is to decrease pain to allow functional improvement concurrently with physical and pharmaceutical modalities. Common injectates used for peripheral joint injections include local anesthetic, corticosteroid, hyaluronic acid, platelet-rich plasma, and mesenchymal stromal cells.