Systemic Absorption of Triamcinolone Acetonide following Intrasynovial and Extrasynovial Articular Injection

Introduction: Laminitis remains a major concern with clinical use of corticosteroids, particularly triamcinolone acetonide (TA). Available literature has not demonstrated an increased risk of laminitis with use of TA, but clinical experience indicates that one-time use of appropriate doses can induce fatal laminitis. Individual case factors influencing laminitis risk have not been investigated, and previous studies on musculoskeletal therapies have focused solely on intraarticular (intrasynovial) injections. This study aimed to determine if systemic absorption of TA varies between intrasynovial (antebrachiocarpal) and extrasynovial (sacroiliac) injection sites. We hypothesized that there would be increased absorption from the extrasynovial site.