Up to what INR can a peripheral joint injection be done safely?
In these higher risk patients I want to know under what circumstances can I safely perform joint injections while remaining on coumadin?
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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.
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