Ultrasound guided injections

Ultrasound guided injections use real-time imaging to help a clinician place a needle accurately within a joint or around a soft tissue structure.

Depending on your condition, an injection may help reduce pain and inflammation or provide information about where your pain is coming from. Ultrasound uses sound waves to create images and does not involve ionising radiation.

A commonly used injection contains a corticosteroid to reduce inflammation, sometimes combined with local anaesthetic for temporary pain relief. Your specialist will explain which medicine is recommended and why.

Your specialist may consider an injection for:

• Pain and inflammation associated with arthritis

• Selected tendon or surrounding soft tissue conditions

• Symptoms that restrict movement or everyday activities

• Pain that needs further assessment to help identify its source

An injection is not suitable for every condition. Your specialist will assess whether it is appropriate and discuss other options where needed.

Your consultant will ask about your symptoms, medical history and previous treatment, then examine the affected area.

An ultrasound scan can help assess joints and soft tissues and guide an injection if appropriate. Other investigations may be needed depending on your symptoms.

For some patients, the response to a local anaesthetic injection can help the referring specialist understand which structure is contributing to their pain.

Before your appointment, follow the instructions provided and tell the team about allergies, diabetes, infection and medication, particularly blood thinning medicines. Do not stop prescribed medication unless your clinical team advises you to.

During the procedure:

• The clinician examines the area with an ultrasound probe

• The skin is cleaned to reduce the risk of infection

• Local anaesthetic may be used to numb the area

• A fine needle is guided into position using the ultrasound image

• The recommended medicine is injected and a small dressing applied

• You may feel a sting or some pressure. Tell your clinician if you are uncomfortable.

The procedure usually takes around 15 minutes, although the time needed for your appointment may vary.

Possible risks include infection, bleeding, an allergic reaction and temporary worsening of pain. Steroid injections may also cause skin changes or temporarily raise blood glucose levels. Injections around tendons carry a small risk of tendon damage. Your clinician will discuss the risks relevant to your treatment.