Musculoskeletal injection

Mayo Clin Proc. 2009 Sep;84(9):831-6; quiz 837. doi: 10.4065/84.9.831.


Patients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians certified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints. This article reviews the clinical presentations of these problems. It also discusses musculoskeletal injections for these problems in terms of medications, indications, injection technique, and supporting evidence from the literature. Experience with joint injection and the pharmacological principles described in this article should allow primary care physicians to become comfortable and proficient with musculoskeletal injections.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Analgesia / methods
  • Anesthetics, Local / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Bursitis / diagnosis
  • Bursitis / drug therapy
  • Humans
  • Injections, Intra-Articular
  • Injections, Intramuscular
  • Joint Diseases / diagnosis
  • Joint Diseases / drug therapy
  • Knee Joint / drug effects
  • Musculoskeletal Diseases / diagnosis*
  • Musculoskeletal Diseases / drug therapy*
  • Shoulder Joint / drug effects


  • Adrenal Cortex Hormones
  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal