Thursday, March 10, 2011
Gout Inflammation: Pre and Post Injection
From my last post on Robert as he presented with the classic gout vs infection decision making process, I decided to injection a low dose of cortisone into the big toe joint, and the other joint in the big toe (1/2 ml of Kenalog 10 with 1/2 ml of 0.5% Sensorcaine plain). He had not improved on 3 weeks of antibiotics from his primary. There was no reason he should be infected. Here again is the pre-shot photo.
Following the shot, he felt improvement that night. When he returned to the office 5 days, 85-90% of his pain was gone. Here is a post injection photo.
This sounds logical, but the fear of infection makes docs think about antibiotics first. So I am glad I got to the patient second!!