Comparing Treatment of Knee Osteoarthritis With Triamcinolone Injections Using 40mg With Landmark Guidance and 20mg With Ultrasound Guidance

The purpose of this study is to determine whether a lower dose of corticosteroid injection with ultrasound-guidance for the treatment of knee osteoarthritis can be as effective as a higher dose that is landmark-guided. With landmark-guided dosing, it may be reasonable to use a higher amount of corticosteroid in order to ensure a sufficient amount of the medication is administered, however these injections carry the risk of side effects. Alternatively, with the use of ultrasound, it may be reasonable to use less corticosteroid, possibly decreasing the risk of side effects and increasing patient satisfaction.

Inclusion Criteria: * Subjects who have already been evaluated within at least one of the 4 study clinics with any of the 3 providers who will be administering the treatment * Males or females age 50 and older * Already had completion of imaging of the affected knee(s) via radiography and/or MRI * Imaging demonstrates osteoarthritis of any severity * Diagnosis of primary osteoarthritis of one or both knees * One or more symptoms associated with the osteoarthritis of at least one knee * Patients able to provide informed consent in English and/or Spanish Exclusion Criteria: * Skin infection at or near area of injection site * Recent fracture of the same knee joint within past 6 months * Uncontrolled bleeding disorder * Intra-articular corticosteroid injection within past 3 months * Intra-articular HA injection within the past 3 months * Intra-articular PRP injection within the past 3 months * Presence of prosthetic knee joint in symptomatic knee * Inability to report symptoms due to cognitive impairment * Complete inability to ambulate, even with assistive device * Any person who is pregnant or less than 1 year post-menopause