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Home > Formulary : Adult > Chapters > 10. Musculoskeletal and Joint Diseases >

BNSSG Adult Joint Formulary

10.5 Soft tissue and joint disorders

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Last edited: 07-02-2024

10.5.1 Local inflammation of joints and soft tissue

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Corticosteroids

  • Treatment with corticosteroids in rheumatic diseases should be reserved for specific indications e.g. when other anti-inflammatory drugs are unsuccessful
  • Corticosteroids may reduce bone density and increase the risk of low impact fracture and can induce osteoporosis. Patients taking (or who are likely to take) an oral corticosteroid at an equivalent dose of 5mg prednisolone or more, for 3 months or longer should be assessed using the FRAX® algorithm and where necessary offered appropriate given prophylactic treatment. See BNF section 6.6  

Prednisolone (TLS Green)

Alternative:

Methylprednisolone (TLS Blue)

 

Local Corticosteroid Injections

Hydrocortisone acetate (Hydrocortistab®) (TLS Green)

Triamcinolone acetonide (Kenalog®) (TLS Green)

Methylprednisolone acetate (Depo-Medrone®) (TLS Green)

Methylprednisolone acetate / Lidocaine (Depo-Medrone® with Lidocaine) (TLS Green)

 

10.5.2 Soft tissue disorders

Enzymes

Hyaluronidase (TLS Blue)

  • Not the intra-articular preparation e.g. Synvisc®

 

Miscellaneous

Dibotermin alfa (TLS Red)

 

10.5.3 Sarcoidosis

Infliximab (TLS Red)

  • NHSE SSC2596 Infliximab for refractory sarcoidosis (excluding neurosarcoidosis)

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