Most injections into the knee or a smaller joint, like that at the base of the thumb, are simple procedures that can be done in a doctor’s surgery. When performed by an experienced physician, the injection is only mildly uncomfortable.
First, the doctor cleans the skin in the area with an antiseptic. If the joint is puffy and filled with fluid, the doctor may insert a needle into the joint to withdraw the excess fluid and examine it. Removing the fluid rapidly relieves pain also because it reduces pressure in the joint and may speed-up healing. Next, the doctor uses a different needle to inject the corticosteroid into the joint.
Injecting a large joint, like the hip, is more complicated and may require imaging tests to help the doctor guide the needle into the joint. Experienced rheumatologists, orthopaedic surgeons, anaesthetists, and radiologists may inject the facet joints of the lower spine.
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Numerous trials (CATT trial, IVAN trial, GEFAL, MANTA, LUCAS) conducted worldwide have shown Bevacizumab injection in the eye to be non-inferior to Ranibizumab injection in the eye in terms of efficacy and safety in AMD. Bevacizumab on the other hand has the advantage of significantly reducing the cost of therapy. However, intravitreal bavacizumab injection has not been approved by the Food and Drug Administration (FDA) and the use in the eye is hence 'off label'. All patients need to be clearly informed when taking written consent for intraocular bevacizumab.