A Retrospective Comparative Analysis on the Outcomes and Complications of Ultrasound Guided Corticosteroid Injection on Tendinopathy in the Foot and Ankle

Corticosteroid injections (CSI) have been used in clinical practice since the early 1950’s for tendinopathy. A CSI mixture typically contains a corticosteroid such as methylprednisolone combined with a local anesthetic such as lidocaine or longer acting bupivacaine. The goal of CSI for foot and ankle tendinopathy is pain control and for the benefit of steroid anti-inflammatory properties. A 2011 study by the American Orthopedic Foot and Ankle Society found that these injections were performed frequently with just over 20 injections performed on average per month by surveyed Orthopedic Foot and Ankle Surgeons.  Due to the frequency of CSI in the clinical setting it is crucial to examine side effects. With such a large volume of injections even rare side effects may become clinically significant. This study aims to identify the frequency of rare side effect occurrence in our own clinical population receiving CSI injections. We have performed a retrospective analysis of tendon injections in the USC Orthopedic clinic since 2/28/18 to examine rates of CSI complications. The study assessed complications of corticosteroid injections with or without ultrasound guidance of the extensor hallucis longus, extensor digitorum longus, flexor digitorum longus, posterior tibial, anterior tibial, and peroneal tendons. The study additionally collected follow up subjective patient data by contacting the patients one time via phone call.