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Clean the injection site with an alcohol swab and allow to dry completely Pinch a fold of skin and subcutaneous tissue between thumb and forefinger Insert a 29 or 30 gauge insulin needle at a 45 degree angle into the pinched tissue Inject the solution slowly and steadily Withdraw the needle and apply gentle pressure if needed Rotate injection sites daily to prevent localized irritation Site Rotation Alternating between medial and lateral sides of the Achilles area prevents accumulation of scar tissue from repeated injections at the same spot

10.1002/art.10626 Arthritis Rheum