Spinal needles clogging

[PMROralBoards]

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I typically use 25g spinals for injections like si joints. For the past few months I’ve had to switch to 22g needles because they seem to get “clogged”. The only thing different with these vs some other injections is using contrast and then depo. Even with 22g, maybe 20% of the time I can’t inject the depo/lido/marcaine after getting the arthrogram. Our EMR comes up with an interaction warning between depo and contrast which doesn’t happen with dex and contrast.

Has anyone run into this or is it just me? Even pulling the needle out and trying to inject against air it can remain plugged.

Thanks for any advice

 

[GatorCHOMPions]

This was mentioned weeks/months back in another thread. Myself and others had the same issue. It's probably your batch of steroid. It seems to have happened less with the latest batch I have. I switched to 22G permanently for SIJ regardless.

 

[oneforfighting]

It’s the steroid. I’ve also switched to 22g for any injection requiring steroids.

 

[BobBarker]

I use 22g spinal always for si joints. Branded depo. No issues with that combo.

 

[manowar rules]

Can you re-stylet the needle and clear the blockage that way?

 

[Ducttape]

that doesnt solve the problem. once you clean out the needle and inject again, those same clumps of steroid plug the needle again.

 

[MitchLevi]

All SIJ is 22g for me, and Depo will clog even that needle if you buy generic.