In each of the following procedures, ultrasound (USS) is used to examine the area to be injected and then often used to help guide the needle into the right place. First, the injection site will be cleaned and numbed with local anaesthetic. The radiologist then watches the needle on a screen and advances it slowly to the target joint or soft tissue (often very small spaces). Once the needle is confirmed in the correct position, your therapeutic injection will be administered.

It is fine to eat and drink as normal before an USS-guided injection. Wear loose comfortable clothing on the day of your injection. Please notify your radiologist if you are diabetic, allergic to any drugs/medication and if you are taking any medication already, particularly blood thinners e.g. warfarin.


What are they used for?

Injections of steroids (cortisone) may be given directly into various joints and soft tissues surrounding the joints to reduce the pain of arthritis or inflammation.

What to expect

The whole procedure under USS-Guidance can take upto 25 minutes. We recommend you to rest the injected joint/body region as much as possible for the first 24-48 hours to help achieve maximum benefit from the injection. There may be some worsening of the pain following the injection in the first 24-48 hrs, but this should subside over the next few days. Please be aware that corticosteroids may take upto a week or so to fully take effect.

Rare, generic complications of steroid injections can include pain, infection, allergic reaction, skin discolouration, skin dimpling, vivid dreams and heavy periods in women. The consent process for injections will allow you to discuss any concerns further.

Talk to your doctor if you are taking Warfarin or other blood-thinning medication as there is a small risk of bleeding into your joint or surrounding soft tissues. You will need to notify the radiologist of your most recent blood test INR level if on warfarin, to ensure a safe injection can be performed.

You should also inform your doctor if you are pregnant or allergic to steroids.


What are they used for?

Dry needling involves repeatedly injecting an abnormal tendon using ultrasound (USS) to guide the needle. This creates mild trauma in the tendon and causes localised bleeding. Blood contains growth factors and proteins that are believed to promote cellular regeneration and subsequent tendon healing.

What to expect

You will be given a local anaesthetic to numb the area, however you may feel some discomfort. The procedure can be effective for most but not all people. You are likely to experience a temporary increase in pain and some bruising for a few days afterwards. You should only walk short distances after the procedure and not do high impact exercise. There is a small risk of infection or tendon rupture. The full effects of this treatment can take weeks to months and works differently to steroid injections.


What are they used for?

Injections of hyaluronic acid are used to effectively help lubricate joints, thereby providing temporary pain relief. Hyaluronic acid is a synthetic compound similar chemically to natural joint fluid. It is of thick consistency and when injected into joints, it can help to work as a lubricant and shock absorber in joints that have undergone wear and tear.

What to expect

You will normally be given a course of injections determined after discussion with your clinician. They should work within a few days and the pain relief should last a few months. Your doctor may recommend repeating the course. You should be able to resume your normal activities immediately after having the injection. Side effects are rare but may include temporary pain and swelling in your joint or a small risk of infection.

Here are animation videos showing you what you can expect during Ultrasound Guided Injections for various joints:

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