What is an ultrasound guided injection?

Many patients ask the question – What is an ultrasound guided injection? So here we shall try to provide an answer to ‘what it is’ and ‘why it is necessary’. Ultrasound is sound waves at high frequency, which are able to penetrate through the skin. Ultrasound guided injections are well used in medicine as they are a harmless way of imaging deep into the body’s tissues. The image allows us to see very accurately all of the different tissues within the body. Ultrasound also help prevent the patient being exposed to radiation or any harmful side effects.

Around a million steroid injections are performed each year in the UK. Steroid injections have also been around for more than fifty years.

Taking corticosteroids orally (tablet formed) for a prolonged period of time, has been known to cause side effects. The principle behind delivering a steroid by injection is to reduce the body’s overall exposure to steroid and minimise the dose required to treat the patients symptoms.

What is an ultrasound guided injection – Patient benefits

The principle for ultrasound guided injection is that we can very accurately guide the injection directly to the target tissue. Maximising patient benefit and minimising required dose.

Research also shows the following benefits from ultrasound guided injections:-

• Reduced incidents of injury
• Reduced overall side effects
• Better patient comfort
• Better patient satisfaction
• Significantly more accurate injection with all injection procedures
• Improved outcomes.

Nowadays more patients are wanting to have their injection performed under ultrasound guidance because of the above reasons, that they improve accuracy, they improve outcome and they reduce the risks of side effects and injury during the injection procedure.

At Complete Injections we always perform an initial check ultrasound scan of the region before giving the injection. This helps us to ensure that there are no reasons why we would not want to inject, that the diagnosis is accurate and that there are no significant structures, such as nerves or vessels, that would become injured whilst performing the injection. We are able to identify a safe and comfortable path for us to deliver the injection.

What is an ultrasound guided injection – Accuracy

We are able to achieve excellent needle visualisation with ultrasound. Tracking the needle from the moment it enters the skin to the target tissue. We are also able to ensure the steroid is delivered accurately at the point which we wish to deliver it. Also, increasingly now, we are using other forms of injection, such as hyaluronic acid, which needs to be delivered into joints or tendon sheaths with the utmost accuracy. Otherwise, it is unlikely to give any benefit. We would always strongly recommend that any hyaluronic acid injection was given under ultrasound guidance.

Also, we are increasingly using techniques, such as –

hydrodistension – where the joint capsule is stretched with a high volume of injection

barbotage – where calcification is aspirated or withdrawn from a tendon prior to an injection.

High volume injections to reduce neovascularization (small vessels which have grown between fat pads and tendons when in painful tendinopathy)

Platelet Rich Plasma (PRP) – where a small amount of blood is drawn from patient’s vein, then refined blood with 3-5 times the normal concentration of platelets is injected into the patients joint or tendon – this is a safe and long lasting treatment for number of degenerative conditions

All of these procedures can only realistically be performed under ultrasound guidance and we would never recommend that these injections would be performed under surface marked assessment.

At Complete Physio all of our expert clinicians, who performed ultrasound guided injections, are dual-qualified as musculoskeletal sonographers. This ensures that they are able to accurately diagnosis and rule out any potential issues from performing the injection. They are also independent prescribes, which means that they are able to fully screen patients for potential medicines interactions or contraindications prior to treatment.

To book an injection, please contact injections@complete-physio.co.uk, or telephone 0207 482 3875.