Imaging guided injections

We offer many kinds of imaging guided injections. These are the most common ones:

Ultrasound guided injections

Ultrasound guided injections relieve acute (sudden) or chronic (ongoing) pain, treat swelling or fluid collections and help to diagnose areas of pain. The injection is performed under the guidance of an ultrasound machine to allow for exact targeting of specific areas.

Hydrodilatation

Hydrodilatation is a procedure for treating shoulder conditions such as adhesive capsulitis (frozen shoulder). During a hydrodilatation the joint is anaesthetised and stretched to help improve mobility and decrease the pain in the joint. It is performed using imaging guidance (ultrasound or X-ray) to ensure the injection goes into the correct part of the joint.

PRP (Platelet-Rich Plasma) therapy

PRPs are a specialised type of injection used to encourage your own body’s healing process. These injections involve your blood being taken via a small tube in your arm. The blood is processed in a machine called a centrifuge to separate the plasma rich part. This is then injected into the area under investigation. For more information please speak to your referrer.

Our MRI scan, MRI contrast and CT guided injections leaflets provide information about other procedures involving injections.

Before your injection

You do not need to do anything differently before your appointment. You can eat and drink as normal. When you arrive at the clinic you will be directed to the imaging department and you may be asked to fill in an injection form asking for details such as allergies and relevant medical history. It is important that you make your radiologist aware if you are taking blood thinning drugs such as Aspirin and Warfarin. For some procedures you may need to change into a gown.

Please come to your appointment 15 minutes early so you have time to complete all the necessary paperwork.

During your injection

Your procedure is performed by a consultant radiologist. For injections performed under ultrasound, the injection site is examined with the ultrasound machine. If you are having the procedure under X-ray guidance, the radiographer positions the image intensifier over the site to allow the radiologist to see the joint.

The skin is prepared with a cold cleaning solution and local anaesthesia may be injected to numb the area. If your procedure is X-ray guided the radiologist uses X-ray contrast to confirm they are in the correct place. The appropriate material (steroid, drug, MRI contrast or water) is injected and the needle is then removed and a small plaster put over the site.

After your injection

Your injection will take around 15 minutes. It may take longer if you are having multiple procedures. You will be able to leave straight after. Most patients feel instantly better because of the local anaesthetic, which can last up to 6 hours. You may be asked to fill out a pain diary after your injection.

Reporting and results

We offer a state-of–the-art picture archiving communications system (PACS) which enables radiologists and consultants, both at Fortius and elsewhere, to access your images. A report from your examination will be available on PACS and sent to your referrer or consultant. All patient information is protected and stored using the strictest security measures. If you have left the clinic and would like a copy of your images, please complete a CD request form or an electronic transfer request form available on our website and email it to pacsadmin@fortiusclinic.com.

If you have any questions about receiving your results or next steps, please speak to our Reception or Appointments teams, your referrer or your consultant’s secretary.

FAQs

Q: How will I feel after the injection?

A: Once the anaesthetic has worn off some patients may experience worsened symptoms for 24-48 hours. You may experience some discomfort in the joint and it may feel bruised. You should take things gently during this time and reduce activities which involve the treated area for a few days. If symptoms become more severe or you feel unwell for an extended period, please contact our nursing team on 0203 195 2458 or 0203 617 6317. If you require urgent medical attention or advice out of clinic hours, please visit your local A&E.

Q: Can I drive?

A: It is recommended not to drive for 24 hours following an injection but this can vary depending on the area injected.

Q: Can I play sports?

A: We recommend that you rest the injection site for at least 48-72 hours following an injection. You should avoid any strain on the affected joint or area for two weeks post injection.

Q: Can I take pain relief?

A: Normal painkillers, ice or heat packs can be used if required. 

Q: Are there any side effects?

A: Although side effects are very rare, they may include the following:

Allergic reaction: if you have any allergies or if you are allergic to X-ray contrast (Iodine), please inform the radiographer. The risk of having an allergic reaction to the dye is 1 in 100,000. This is slightly more common if you have other allergies.

Bleeding: although rare, it is possible that the injection site will continue to bleed. The bleeding should stop if you put pressure on the injection site. Please contact the clinic if the bleeding does not stop after 1 hour.

Skin changes: very rarely (in 2-4 per cent of patients) the skin near the injection site may discolour and become photosensitive.

Infection: it is possible for the injected area to become infected. This is rare - only occurring in 1 in 25,000 patients - but serious. If you have concerns please contact our nursing team on 0203 195 2458 or 0203 617 6317.

Flare response: steroids may cause pain, swelling, redness and warmth in the injected area in up to 25 per cent of patients. You should take a non-steroidal anti-inflammatory agent such as Ibuprofen. Paracetamol can be taken at the same time. Ice packs can also help reduce the swelling.