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Previous protocols called for 10% hydrocortisone
coupled with a cream base. This made the ultrasound have to
"push" the hydrocortisone, which is an insoluble molecule,
through yet another layer—the cream! Because of this, there was often
reflective shutdown and poor penetration. Dexamethasone sodium phosphate
is a soluble molecule, therefore it can be incorporated directly
into an ultrasound gel (this must be compounded to achieve a 0.4%
concentration). What could be better—a more powerful effective drug, no
reflective shut down, and less expensive!
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