Ultrasound Guided Injections

Injuries to joints, tendons and muscles or wear and tear diseases such as arthritis may benefit from injection of medication into the painful area. Furthermore, in order to diagnose certain orthopaedic diseases an injection of medication is often helpful to pinpoint the problem.

Commonly injected medications include cortisone, hyaluronic acid (such as Monovisc, Synvisc, Durolane), or platelet-rich plasma (PRP). Administering the medication in the right place is, of course, of paramount importance for example ensuring the medication is injected into the joint itself, not accidentally into the surrounding soft tissues.

Many injections, such as knee joint injections, have traditionally been injected ‘blind’ meaning based on landmarks and feel without direct visualization. In experienced hands, the success of these ‘blind’ injections is good with typical hit rates for the knee above 80%, for example. Some joints are much harder to access because of more difficult landmarking, such as the hip or shoulder joint. Injection of medication into diseased tendons is difficult without the help of imaging, such as ultrasound.

One way to try to increase the chance of successful placement of the medication is with the help of imaging, such as X-ray or ultrasound. This drastically increases the successful placement of medication into the appropriate location which is important to make sure the treatment is effective and ‘diagnostic injections’ allow accurate interpretation of the results of the injection.

Ultrasound guided injections are administered in the same way as traditional injections. The only difference is an ultrasound probe is used to visualize the needle entering the appropriate location prior to administering the medication. This can be especially important for the patient when administering expensive medications such as Hyaluronic acid (e.g. Monovisc/Synvisc) or PRP.

Some image guided injections are available at local hospitals in the radiology department but the wait list is often long. At POSM we are happy to offer expedited image guided injections. The cost of the ultrasound guidance is not covered by the government. Please contact your surgeon’s medical office assistant for help if you may be interested.