Up to what INR can a peripheral joint injection be done safely?

My clinic frequently sees many patients who could benefit from peripheral joint injections. Unfortunately, many of them are on coumadin and are somewhat high risk for stopping anti-coagulation.
In these higher risk patients I want to know under what circumstances can I safely perform joint injections while remaining on coumadin?

Review this 1 answer or add your answer below.

This study (Safety of joint and soft tissue injections in patients on warfarin anticoagulation.) suggests an INR < 3 is safe for numerous joint and soft tissue injections. They list several procedures and just note no hemarthroses or other complications. But it's a limited group size.

Another study (Determination of a safe INR for joint injections in patients taking warfarin.) also shows a similar result in a limited population, specifically for knee and shoulder injections. The highest INR in that group was >5.

Submit Your Answer!