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Although soft tissue (fat) atrophy and local depigmentation are possible with any steroid preparation injected into soft tissue, the risk can be modulated by using a corticosteroid agent with appropriate solubility. A less soluble agent such as triamcinolone acetonide or hexacetonide is preferred for intra-articular injections of deep structures, such as the knee, elbow, or shoulder. A more soluble agent, such as betamethasone sodium phosphate and acetate or dexamethasone sodium phosphate, is preferred for soft tissue injections of bursae, tendon sheaths, metacarpophalangeal joints, proximal phalangeal joints, and the carpal tunnel.