Corticosteroid Ankle

Corticosteroids are sometimes used in the treatment of severe symptomatic gout, by intra-articular, systemic, or subcutaneous routes, depending on the degree of pain and inflammation. The most commonly used oral corticosteroid is prednisone. The recommended dose is 30-50 mg/d for 1-2 days, tapered over 7-10 days. Intra-articular injection of 10 mg (small joints), 30 mg (wrist, ankle, elbow), and 40 mg (knee) of triamcinolone acetonide can be given if the patient is unable to take oral medications. 

Viscosupplementation via intra-articular hyaluronic acid injections is a conservative treatment modality to be used in conjunction with other conservative management modalities including activity modification, physical therapy, analgesics, nonsteroidal anti-inflammatories (NSAIDS), and intra-articular corticosteroid injections. It is only approved by the FDA for treating osteoarthritis of the knee. Off-label use has been reported for treatment of osteoarthritis affecting the earpometacarpal joints of the thumb, apophyseal joints of the lumbar spine, hip, ankle, and foot [1, 34, 40, 92, 101]. 

Peroneal tendon tears can be observed in patients following ankle sprains or with a history of chronic instability, especially if they are affected by systemic disorders such as rheumatoid arthritis and diabetes mellitus or are receiving corticosteroids (Kraus and Brodsky 1998 Wang et al. 2005). Clinically, the rupture of peroneal tendons leads to inability to evert and cavovar us foot Tears of the peroneus brevis tendon are most common and present with a typical longitudinal configuration, commonly referred to as split or fis-... 

D Agostino MA, Ayral X, Baron G et al (2005) Impact of ultrasound imaging on local corticosteroid injections of symptomatic ankle, hind-, and mid-foot in chronic inflammatory diseases. Arthritis Rheum 53 284-292 Delfaut EM, Demondion X, Bieranski A et al (2003) Imaging of foot and ankle nerve entrapment syndromes from well-demonstrated to unfamiliar sites. RadioGraphics 23 613-623... 

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