Professional Documents
Culture Documents
DIPROFOS'
'l ml contains:
2 mg of betamethasone in the form of the phosphate
+ 5 mg of betamethasone in the form of the dipropionate
7 mgof betamethasone
EQUIVALENCE
OF SYSTEMIC CORTICOSTEROI DS
(from
25 mg
4mg
4mg
2rg
53 m9
13 mg
66,5 mg
10,5 mg
10,5 mg
5rg
2rg
2mg
80 mg
20mg
100 mg
16 mg
8rg
3mg
3mg
133 mg
33
13 rng
5rg
5rg
160 mg
l6
6mg
619
186,5 mg
18,5 mg
7ng
7^g
20
mg
200 mg
ANII
DURAIION' OT ACTION
's
I
36
ho,ll)
mg
mg
0,75 mg
166,5 mg
26,5 mg
26,5 mg
40 mg
200 mg
32 mg
32 mg
46,5 mg
233 mg
37 mg
37
250 mg
40
40 mg
20 mg
7,5 ng
7,5 nW
50
mg
mg
mg
ng
ntg
tl
0,8
t0
25
25
0,8
0,8
0,5
INTIAMMATORY ACIION
SOUUM REIENTION
l6
0,75
TNJECTIONS
I
i
oF THE HAND
INJECTIONS
AND INFITTR/NTIONS
OF THE KNEEAfthough a painful and pxsibly swollen knee will readily evoke a diagnosis of inflammatory infective, or degenerative joint disease, it should be remembered that the knee is a common site of abafticular or soft tissue rheumatic dinrders of various types
because it is prone to injuriu that may affect its tendons, iE synovial bursae, or iE ligaments. This must not be ignored despite
the complexity and the variety of symptoms presented by various clinical
picturu.
From the preventive point of view it is important to detect general disorders or static constitutional or funclional abnormalities that could lead to degenerative processes in the tr'ssueE or recent traumatic lesions which, however slighg could have the
same consequenc es if neglected.
From the curative point of view, an accurate clinical and radiological diagnosis of the chronic lesion is needed in order to
A . MEDIAT ROUTE
Indications
IECHNIQUE
Needle :50 mm needle of 8/10 diameter.
Dose to inject : 1 ml,
his
backwith
knee
lightly flexed.
kneecap.
The injection site is located:
and he base of
he ptella.
The
nedle
is
insefied
tl
hth
of 2 cm.
d*
.i
- ANTERIOR
ROUTE
TECHNTQUE
Needle : 50 mm needle of B/10 diameter.
Dose to inject :
ml
is placed
C.
IATERAL ROUTE
TECHNIQUE
l'{eedle :50 mm needle of B/l0 diameter.
Dose
to iniert : 1 ml.
is laying
slightly flexed.
oi2 cm.
the ntercondylopatellarsulcus,
2. Subpatellar injection : in
mid way beh\een the apex and the base of the patella.
The needle is inserted to a depth of 2 cm.
POSTERIOR ROUTE
Ind icatio ns : popl itea L cyst - eiiuslon (monarth ritls, osteoarth ritis).
TECHNTQUE
N
Dose
to inject : 1 ml.
with
pu'
as
ry:-L
in the medial part of the pop iteal space, just medial to the
,,...-..'.-.--.--
thcrc
is ,r risk
INJECTIONSAND
INFIUTR/ATIONS
OFTHE SHOULDER
Soft tissue rheumatism : "This most commonly takes the form
carried out safely and with the utlieved by tocat injection. However this simple procedure mustbe carefully thought out and
without technical knowmost care : it should not be a reflex ruponseio all localised disorders carried out indiscriminately,
infiltrations must only be
ledge, and anywhere, in a place that is not pefectly clean or on the sports field..Local
risk
by qualified peisonnel under rigorously aseptic conditions; to ignore this rule is to expose the patient to the
adiinktered
A.M. RECORDIER
acromioclavicular osteoarthritis.
inje(t:
1/2 ml.
is located:
the acromioclavicular joint space : this joint space is
easily identified if the ioint js dislocated or affected by
'in
osteoarthritis.
Thc infiltration is made into this joint space with the needle
inscrtcd obliquely downwards and medially. The needle must
not be inserted to a depth of morethan 1 cm.
.1,,
:|
i,rl
ii
,.,1.
lndications
f,!tcdlt: l5
tlimcicr ntd
nll
P0s!i.
Dlsc io injert
r,,r r oril n!
1(
nt
rliltratior:lhcpalicntirlr,uul I tlrt:ift
,rhd!cl.d
,ri
l;'.
'i
,rler,r
l\
j;qllr,ris1'1
lt,t)r(,n 5ll)Lt
1'
tlli ,trrf/ri,I
us.
r\rr , "'
rs
l|
s (x alr'fl
iltt
hLrnl,rus
w:
{
\lI t
I
I
,
t It
(_nt
rL
"''
ii\
Thf ini('ctio
."I
'r
clnltcs
It
r'
iilIp|d:'lt]]ffidlll
frlr{:11}rt]J'll i!;l
qvpes), capsulitis,
fhcumak)id arthrltis.
Needle : 25 mm needle of 5110 dhmeter with a shod bevel.
Dose
to inje(t
I ml.
plaled
1n
to
belorv the
in1.er
The need
iftii
s inserted
: I ml.
is placed
jf
1 cm beloi,,;
a[nm]of
aspeci ot the
ffi
| {r4
ir
:ir ri'r ;l
'/-
ti,--
[ 1.ili]d|,,]}
::liF fF'll[i],;,lii1ii,:il'iilril;1.:l;
d0ltrldltis
pla
ns
detded l)t
tl
2l
mm needlc oi
5i
ll
l0 dlanre'tir.
I ml.
tl e prtient
rs placecl
pen(1Lilt.
\liNlrr
opp(,s (r(
lhl r orvlrglnr
towads thc
I
I
Iito
rl\, lrlwtu
lr
epicondylitis 66%
dinrders of the
headofradius 20%
epitrochleaitis 9%
olecranon
A.
pain
TAIERAT ROUTE
pulled ligamenr
TECHNIQUE
l{eedle :25 mm needle of5/10 diameter.
Dose to inject : 1 ml.
supinated.
a. epicondylitis - epicondylalgia
The injection is made into the site
ofthe pain
(butthere
is a risk
dinous tissues),
until
pinting
2%
2%
1%
1%
B.ANIERIOR
AND MEDIAT ROT,IE
a
TECHNIQUE
Needle :25 mm and 5/10 diameteror 50 mm and B/10
diameter needle with short bevel.
: I ml.
Infilnation: with the elbow extended, the injection site
Dose to inject
is
l.cated along the distal part olthe lateral margin ofthe tendon
ofthe biceps. The needle is inserted perpendicular to the skin
until it
b.
is
of the biceps.
TECHNIQUE
l,leedle : 25 mm needle of 5l10 diameter.
Dose to inject : 1 rnl.
rs
is made
into$issiteof muscle
proximi-
condylc of
tion sitc is
$c
to the
is
C. POSTERIOR
TECHNtQUt
Needle:25 mn needle oi
Dose to injert : 1 ml,
srlg6;rr.,.r.
sites
ofthe olecranon.
lendon.
b. for tricipital bursitis : with the elbow flexed at 90' identili), the
epicondyle and olecranon. The injection s'te is located beneath
D. POSTEROIATERAI ROUTE
Indications : disorders affecting the head of the adius (epicon- dylalgia), osteoarthritis of the elbow, involvement of the elbow
in rheumatoid monarthritis 0roJigoarthritis.
r
TECHNIQUE
Needle :25 mm needle of5/10 di;meter.
Dose to inject
: 1 ml.
Infiltration : the elbow
joint c.rpsule.
B.WRISTJOINT
lltliraiions : sequelae of injUry (sprain, injury to the wristor wrist
joint), synovitis, rheumatoid anhritis. Osteoafthritis ofthe wrist
(very rare).
TECHNIQUE
,nli.edle : 25 mm needle o{ 5/10 diameter.
ml.
the dorsal aspect ofthe wrist, with the hand pronated and resting
[.
!,,r1{ri!olrs
TECHNIQUE
fifldjr
is p aced
flaton
a hard surface.
After locating the base of the stvloid process of the ulna and the
radius, the injection is made about 2 crn irom the border of thc
ulna. The need e is inserted perperdicular to the skrn.
D - CARPOMFTACARPAT
JOIT{TOFffETTIUMB
Indications
li2 to 1 mL.
Infrllration: the iirsllretacarpaibasc is ocated on thcback ofthe
hand. The osteo-articu ar intersection formed bv the
cond mchcarpal bones and the napezium
is then
identiiied by pal
passes
ilt
lleh{een the lrapezlLrm and the heads ofthc first ard second
metacarpals. The
AI{D
II{TERFT{A,TANGEAI- JOINTS
IECHNIQUE
eed le : 15
"l
Dose ro
dorsal sidc of the finger, to the side oi thc cxtcnsor tendon ilate
ral y
r-rr
necdle
is i,ery pa
iluorane) is rcconrnrendecl.
iff4:!flffith,fi",
lndications : lrr ht
of,
ll]h[AlAl{GFAt pADS
fllanrmat of, bursitls.
TICHNIQUE
Needle :
2i
intradcflrir need r.
Do5t to inj3ct
lll
ntl.
lrfiitration : lhc prds aie on the dorsal irce c-ri the proxinral
irtcrphrhngr',rl loinls Ihe.v are oi soitcr consistencv than
lirLr lr,rrrl's
in
jt'r t
rrr
xlcs,
irrlr
' .r'l ;. | .
n ihe region
of
7I
f .-'.;--:,'.'::,
2. Lqlerol ospecf
A . SIYIOD rc(ESOFIHE MDII'S
Indi(ations : radial styloiditis,
TECHNIQUE
Needle :25 mm needle of5/10 diameter.
Dose to
inje(t:12 to 1 ml.
sweljilg. siloiditjs
B . TENDON SHEAI}IS
OF
ME
TONGABDUOORANDTHE
SHORT DfiENSOR OF THE THUMB
Indications : De Quervain's tenosynovitis.
TECHNIQUE
Needle :25 mm needle of5/10 diameter.
Dose to inject: 1/2 ml.
In[iltlation :it
mical snuffbox
is
ind
The injection is made into the lateralface of the wrist and hand
at the tip ofthe styloid process of the radius, the needle being
angled upwards in order to pas into the synovialsheath.
3. Pclmqr
A.
CARPAITI.,!f{NEI.
cr
rP,r I
tun
ne
TECH\QUE
li
mnr nccdle oi
ir'l0 diamctc'r.
tnt.
the hnnd Jfd wf
c ther the
ot the second I
nfd
are exam
ln, .,t'
n the r,rnter or
or
errrc
. orthcs(rlo
tul)ercie, rnal just fredial to the palmlr s longus rvhrah Iorms one
the \\,ri\1.
Th-" inje,ctiirn is
angkrlvet
shar'p v
doivn
.r1
\,(' lo tlrc
.pe\ oilhe
llrf
r('!t'
Irrxr& u
l)o! lior.
pl
th thc injeLt
r i this slrould
or
L)ui
hrppen do nol
mo\c thc fccdlo lo,tnotlter
B.
l:r
.irit
TECHNIQUE
li
mm needleol
l/2 to
"
5/ uoramelcr.
1 ml.
nerveorthe ulnarartery
is
accidentally punctured do
not proceed rvith the lnjcction but move the needle to another
posilron.
C.
TRIGGER FINGER
TECHNIQUE
Needle :25 mm needle
of5/j0 diameter.
ose
palpatiOn,
lsually
is detected
by
and
DUPUYTREN'S CONTRACTURE
Indicatioul
lLtpgytrgn's contracture.
TECHNIQUE
irle(t .l/2
to
ml.
oi
s".
r""
deep lM iniecflon.
i.
"r'f.
of 0 2 ml/cm? uo to o moximum of
l,
ia.g""
ai*"
ml per week.
doso. Dosaoe:lb?m
bv deep Mlnleclion
otlriil;"tu"r,ti;;""irol
syndrome, ulceroiive colitis, regionol ileitis, sprue, podiotric condit'ons {bursilis under helo#o durum, hollux 'igidus, digiti quinlivorus) drsorden requiring subcon
i"i*ri.". -'ri.osteroid responsiuellood dv"scrosios nephri[s ond nep\rolic syndrome
cdrenocortitol ins,,fficiencv nov be treoted with DIPROI-OS Sterile Aqueous
brimorv o,
'econdorv
'
Susoeision bur should be s,.,pple'nenhd wi$ r'rinerclocorticords Dooge b 2 ml bv deep M n ector
dridLol
lE'rierenrs,
ooierf5
lod
b
fie
m,rsl
&
b
ruhrcul'n
syr
nge
do'oqe
.
oy
odm
st'eo
'l'e
0.25
-l
Lcro]ry
$" ,.',e, ol{e d oroe,. {" ,"pne ono {e po[irr s oo lirv olerole hp cor oseroid llre* of$e p'oPemes ol Dl
i.
i*.i,i.i
DIPRO
PPOFOS'corc"re" ocoiono.,iles,o"i.lhreqr,edorlT-orelyfcolcJ'Ierluseoforonoslrercisdesirobe
fOS mov h -ixeo n tle sv;rqe lro r *e ompoulel -iF procorre hC r% or 'rdoco n" HCI I %
& odr" sre'"d inr,o"eno ny. .r...rsr oe oo-inisrr"d urcer . gorcr. y oseptic .ondi ons
C"J-' O,|,CO;OS
hcue sfo*n thot locol oi qenercl rreotmenr w fi D PROFOS s *ell toleroied There ls
r'ioh
Si*-"tt*tt , r".""i c|l"i.a
-"r*'
{o side eFe.rc\o'ocle isric or{" co- cosrelo'd dr,gs -01de'eop howeues'ile.eff*ts retoted u dole ond durolion of heolmenl ixlude Cush'rg's syndrome, od,enol suppresion (specio
precou.ors o'e rxessory d.:.rnq drets adLcdby5rge] -oumo or se''our diseo,e) osleotoosis gosl'(uke'w'\
; + of pcro'olio r o1d .oenorrroq" d'sr,rbo rce o[ glucose m obo[sm wilh $ ocerbo'on ol diob'es -e li'us: e 'ocer
o,;i*'i". poie.r cotobo.nm r eqotrye na.ogel oo or(e go*h e.odo o" rr cl,Ldren poly'
borlo"'.,
*ovso
The
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,il
^o
ohoo'oossociori"rr*eqfq"nordoed.r"o,''e*or{ep'oong"docriorolDoROFOSordthe'esitirgrhlb
-oy lr okop"i o{ feodrerolco-e, ol-e' t'eo'-erolo le* -eeLs ord
tron iferooqeroL s od'e.olixie or the
'"
mov
L"t"
oenislbr
ku-i
tid"*fi".rt
r"ntl
disorders, spontoneous hocbres, mus.le diseose, rolsed nho oculor pressure' olrophy
ro lv considered to be onrroindicotions
nle$ no ono
moie of its inqredienis Otlrer conko ndicotlons : oclive or olenl goslr'c lkerolion primory gloucomo reni
reno iorlLre
,toros,s. o'ue_'c., lis lyplerso. rl'o'bopl ebit' o'reopo osis d oberes C"J^ rg s 'yndtome
oy
cl'oti croer
o.do.:"o' c. onc
oo
eror u'o
or
<O DIPROFOS
so regirrerql todemorl o{
SCHER
NG PIO1JGH Corp
USA
wos 1"'
DIPROFOS
RAPID RELIEF
LASTINC RELIEF
PAINLESS INJECTION
SAVINC OF CORTISONE
t*=E;:3t
=---
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Schering-Plough Corp.