Ultrasound Guided Joint Injections
Duration
20 - 30 min
Treatment Type
Guided Injection
Recovery Time
2 - 3 days
Ultrasound, also known as sonography, is an imaging method that uses high-frequency sound waves to produce real-time and dynamic images of the body. Ultrasound is increasingly being used to assist Physicians in performing injections of different muscles, tendons, ligaments and joints. With the advancement of this technology, ultrasound machines have become more powerful with much better image quality. This has allowed treating clinicians to be able to use real-time, point-of-care ultrasound, to assist in the treatment of their patients when performing injections into the knee, shoulder and hip.
Why Chose Ultrasound
Why Chose Ultrasound
The use of ultrasound improves the accuracy of the injection of corticosteroids, hyaluronic acid or other therapies such as Platelet Rich Plasma. Ultrasound can also be used for joint aspirations to rule out joint infection or gout. Lastly, guided injections can be used diagnostically to help determine which structures are generating the patient’s pain.
Real-Time Solutions
Real-Time Solutions
Ultrasound-guided injections allow the practitioner to visualize the needle in real-time as it enters the body and traverses to the desired location. This assures that the medication is accurately injected precisely at the intended site.
Treatment Types
Treatment Types
Typical conditions include osteoarthritis, rheumatoid arthritis, labral tears, muscle tears, ligament tears and tendinopathies. Injections of Platelet Rich Plasma (PRP) have been used in the management of inflammatory and degenerative conditions when rest, ice and anti-inflammatory medications fail to provide adequate relief. In patients with severe Osteoarthritis awaiting replacement surgery, Hyaluronic Acid (HA) fillers can provide lubrication and act as a protective cushion between the bones to absorb the stress applied to joints during movement. This can drastically reduce pain in the months while awaiting surgery.
Benefits
Radiation Free
Ultrasound allows the provider to visualize the joint making injections easier and more accurate. Unlike Fluoroscopy (X Ray guided injections) Ultrasound guided injections do not expose you to repeated doses of radiation.
Precise Visualization
Ultrasound allows us to visualize the bony joint as well as all of the surrounding structures. Under ultrasound guidance the product can be placed precisely in the anatomically correct position for optimum results .Moving the ultrasound probe the practitioner can visualize what may be in the path of the needle and avoid any unwanted complications.
Accuracy
With ultrasound guidance the accuracy of nearly every joint injection exceeds 90% and approaches 100% in many. Additionally, ultrasound guided injections have been shown to be less painful than blind injections.
Types of ultrasound guided shots
Platelet-rich plasma (PRP) can accelerate tissue repair in damaged tissues. PRP injections can be broken down into two steps. The first step is preparing the platelet-rich plasma for injection. Our doctor draws a small amount of blood from your arm. The blood is centrifuged to extract the plasma and platelets. The valuable, concentrated solution is rich in platelets and other bioactive substances that enhance tissue regeneration and healing. Then, under ultrasound guidance, the PRP is injected into the injured area to stimulate and accelerate your body’s natural healing process and reduce pain. The aim is to return to normal function. Even if severely damaged tissue you can experience significant improvement in symptoms and function. Ultimately we try to eliminate the need for more aggressive treatments and long-term medication, ultimately delaying or avoiding potential surgery. Recent evidence shows that doing 2 injections 6 weeks apart greatly improves the outcome and duration of the Platelet Rich Plasma (PRP) injections. Involving a physical therapist post-injection also greatly improves the outcomes.
Commonly Injected Areas
Knee
Ultrasound can help evaluate a variety of structures within the knee including the quadriceps and patellar tendons, the extra-articular (outside the joint) ligaments, and some meniscus injuries. It can also be used to see if there is fluid within the knee joint. Imaging can be particularly helpful in patients with difficult anatomy or overweight patients.This greatly improves the accurate placement of the products injected into the joint.
Shoulder
Studies have shown that Ultrasound of the shoulder is just as sensitive and specific as MRI in the diagnosis of rotator cuff injury. Ultrasound can facilitate the more accurate injection of multiple different structures in the shoulder including the Acromioclavicular (AC) joint, the Glenohumeral joint (the true shoulder joint), the biceps tendon, and the subacromial bursa.
Hip
At Revive our physicians have advanced training in hip injections. Hip joint injections may be performed for osteoarthritis of the hip and the diagnosis and management of labral tears. Ultrasound Imaging is crucial when performing injections into the hip joint due to the deep location of the joint and the proximity of large blood vessels and nerves.
Risks and Complications
- 1
Allergic Reactions
Since we are injecting your own blood products there is no risk for allergic reactions with the use of Platelet Rich Plasma (PRP). The risk with steroids and Hyaloronic Acid (HA) is extremely rare.
- 2
Side Effects
When injecting cortisone it may result in mild palpitations, hot flushes, insomnia and mild mood disturbance. This usually resolves spontaneously within 24 hours and no treatment is usually necessary..
- 3
Joint pain and stiffness
You may develop ‘post-injection flare’ which is joint swelling and pain several hours after the corticosteroid injection. This only occurs in approximately 1 out of 50 patients and usually subsides within several days.
Frequently Asked Questions
What are ultrasound-guided injections and how do they work?
An ultrasound-guided injection is a procedure that uses real-time ultrasound imaging to accurately deliver medications or therapies into specific areas of the body, such as muscles, tendons, ligaments, and joints.
Why choose ultrasound for injections?
Ultrasound improves injection accuracy, especially for corticosteroids, hyaluronic acid, and platelet-rich plasma (PRP) therapies. Using an ultrasound the overall accuracy rate is over 90% versus 65% for blind injections for all joints, in the most commonly injected joints like the shoulder and knee, the accuracy rate for ultrasound guided injections is more than 98%. IUltrasound can also assist in diagnosing the source of pain by visualizing structures like tendons and ligaments around the joint.
What conditions can be treated with these injections?
These injections are used to manage various conditions, including osteoarthritis, rheumatoid arthritis, labral tears, muscle tears, ligament injuries, and tendinopathies.
Are cortisone injections suitable for pain relief?
Cortisone injections are commonly used to relieve pain and inflammation in specific areas. However, they may have limitations due to potential risks like tendon rupture.For this reason we limit the use of corticosteroids and prefer the use of Platelet Rich Plasma (PRP) or Hyaluronic Acid (HA) preparations.
Why is ultrasound preferred for should injections?
Ultrasound is as effective as an MRI in diagnosing rotator cuff injuries and allows for precise injections into various shoulder structures, including the AC joint, Glenohumeral joint, biceps tendon, and subacromial bursa.
Which areas of the body are commonly treated with these injections?
Ultrasound-guided injections are frequently performed in the knee, shoulder, and hip joints. These areas benefit from the accuracy and safety of ultrasound guidance.
Do I need imaging like an x-ray before the treatment?
We need recent imaging of the joint to confirm the arthritis. The minimum is an x-ray of the affected joint in the last 6 months. If you have not had any imaging we will organize this for you before the injection.
Are these procedures covered through the BC Medical Services Plan (MSP)?
Although some parts of the investigations like x-rays will be covered by MSP, the ultrasound in injections is not covered and is private pay. Many extended benefit plans and Third party insurance companies like Bluecross, Manulife etcetera will cover part of the cost of the Hyaluronic Acid (HA) filler and some will cover the Platelet Rich Plasma (PRP) injections. Please inquire with your specific plan before your appointment. A detailed receipt will be provided for you at the time of the injections. We do not claim from your insurance and will expect full payment of the procedure by the patients on the day of the procedure.
Do I need a referral to get the treatment?
No, you do not need a referral and can contact our clinic directly.
