Ultrasound-guided joint injections

In partnership with Camden MSK, our department has agreed to provide ultrasound-guided joint and soft tissue injections to patients referred by the Camden community MSK services.

Why an injection?

In some cases your condition may respond to an injection to help settle your symptoms. Injections are usually given in addition to physiotherapy in order to help your recovery. 

What is in the injection?

Your doctor will inject a combination of local anaesthetic and corticosteroids. For certain conditions, for instance frozen shoulder, additional solutions are used and your doctor will explain if this is the case.

What are corticosteroids?

Corticosteroids are anti-inflammatory medicines used to treat different conditions (e.g. corticosteroids inhalers can be used to treat asthma). When given as an injection they can be used to reduce pain and swelling in a joint. Corticosteroids are not the same as anabolic steroids, which are used illegally to increase muscle bulk. 

What areas are injected?

The common injections to relieve your symptoms include:

• Joints (e.g. shoulder, wrist, hip, knee, ankle)
• Bursitis (e.g. shoulder subacromial bursitis, greater trochanteric hip bursitis)
• Tendons (e.g. trigger finger, trigger thumb, tenosynovitis)
• Nerves (e.g. carpal tunnel syndrome)

What are the risks?

• Joint and soft tissue injections are widely used and generally safe, with a very low risk of complications. Adverse reactions are rare, but may include:
• Allergy
• Bruising/bleeding
• infection
• Skin discolouration or skin fat reduction (atrophy) at site of injection

If you are diabetic you blood sugar may be slightly higher for 1-2 weeks, but this is usually a short-lived effect Your doctor will take every necessary precaution to reduce the risk of complications and will discuss these with you.

Is the injection painful?

There may be some discomfort, sometimes it can be sore for a few hours, and you will be advised by your doctor how to best manage this. 

How is the injection done?

Firstly the skin is cleaned with antiseptic. Under ultrasound guidance a small needle is then gently put into the affected part and the solution is injected through the needle (see picture). 

Why ultrasound-guided?

The use of ultrasound allows your doctor to see the area that needs to be injected and accurately place the needle. This improves both accuracy and safety of the injection.

Medications: If you are taking Warfarin, please ensure your INR is <3.0. Other blood thinning medications (e.g. rivaroxaban, dabigatran, apixaban, aspirin & clopidogrel) can usually be taken as normal before the procedure. Please seek advice from your consultant or medical team if unsure.

Aftercare

Your doctor will discuss how look after yourself after the injection and how to spot signs of complications (e.g. infection).

How to contact us

Patient services
The Royal London Hospital for Integrated Medicine
60 Great Ormond Street, London WC1N 3HR

Tel: 020 3448 2000 Switchboard: 020 3456 7890 Fax: 020 3448 2004
Email: uclh.enquiry.rlhim.patients@nhs.net (not for referrals)
Website: www.uclh.nhs.uk