Ultrasound Guided Injections

What is an ultrasound guided injection?

An ultrasound scan is a diagnostic procedure that uses high-frequency sound waves to create images of parts of the body. The high-frequency sound waves bounce off different anatomical structures, creating ‘echoes’ that are picked up by the ultrasound probe and converted into a moving image that can be seen in real time by the physician. Unlike other imaging resources, there is no radiation exposure to the patient or physician, making this a very safe imaging technique.

Once the exact location is found, a needle will be guided into the target area using the live images on the screen to administer the medication into the exact location for optimal efficacy and safety.

What are the benefits

The primary benefit of an ultrasound-guided injection is that the medication is administered directly to the target site. This may be a small joint, tendon sheath, bursa or around a nerve. Ultrasound allows clear visualisation of all of these structures and allows for the best possible results by administering the medication into the exact area of pathology.

• It has also been shown to reduce the risk of needle stick injury from an injection, which is especially important when injecting around sensitive structures such as nerves or where structures lay close to major blood vessels and arteries.  
• Ultrasound guidance allows for certain procedures that can only realistically be performed this way, such as hydrodistension for frozen shoulder, barbotage for calcific tendonitis and high-volume injections for Achilles and patella tendinopathy. 
• Patients find them more comfortable. Ultrasound allows us to plan the most direct needle route, all while minimising avoidable re-entries or ‘wiggling the needle’ to successfully enter a joint space.

What happens during the procedure?

• The exact procedure will be discussed with prior to going ahead. We will obtain written consent for this procedure making you aware of the potential benefits, risks and alternative options.
• You will be placed in a position of comfort, depending on the targeted structure this may be long sitting, side lying, supine for hip joint injections and prone for spinal injections. This will also allow the physician to clearly access and visualise the target structure.
• Once the exact area has been found on the ultrasound machine. The area will be cleaned with chlorhexidine spray and swobs to minimise any infection risks. The probe is sterilised and the images are obtained using sterile Ultrasound gel to avoid any cross contamination.
• A needle will be inserted initially typically of local anaesthetic aimed at providing local anaesthesia but also confirming exact needle placement. Once confirmed placement is visualised the injectate (Steroid, HA, PRP, Arthrosamid) is then administered accurately into the intended structure.
• A dressing will be applied at the end of the procedure which need to be kept clean and dry for at least 24 hours.