A steroid injection is treatment for inflammation. Ultrasound is used to accurately locate the exact site of the inflammation. The radiology doctor will insert a needle and guide it into the area of inflammation with the ultrasound machine. Then he will inject a mixture of local anaesthetic and steroid into the area of inflammation. The needle is removed and a bandaid is placed on the needle insertion point. The needle is a similar size to a vaccination needle and thinner than a blood taking needle, so the bandaid is only needed for approximately 2 hours. Then it can be removed.

Possible side effects of a steroid injection include a red face/hot flush (where you feel hot all over for a few minutes to half an hour, and which resolves by itself and is not dangerous) and temporary destabilisation of diabetes (if you are taking insulin for diabetes, your sugar blood test results may go up temporarily, but will settle again in 1-2 days). Rare complications include bleeding and infection. If this occurs, please see your local doctor to determine whether any treatment is required. Some people get dizzy during or straight after an injection, which is a reflex body reaction to needles. You may require a short period of lying down straight after the injection (the technician will advise you if this is required) and this will resolve in time. Please let the technician know if this has happened to you before.

Some injections are more painful than others. An injection into a shoulder bursa is only mildly uncomfortable whereas an injection into the hand can be painful. If you prefer, you can bring with you an anaesthetic patch (EMLA patch, you can buy these at a chemist or pharmacy) and we can apply this beforehand. However this will involve coming to the xray department at least an hour before your injection appointment, and there will be an extra charge for this service.

It is advised that you avoid heavy lifting or exercise for at least 2 days after the injection. If you are undergoing physiotherapy treatment, you can recommence this after approximately 7 days (or speak to your physiotherapist for more advice).

  • Ultrasound Joint Injection

    Celestone Chronodose and marcain mixture is injected into the joint. Joints include the shoulder joints (glenohumeral joint, acromioclavicular joint), the elbow joint, the wrist joints (radiocarpal joint, ulnocarpal joint, around the triangular fibrocartilage, distal radioulnar joint, scapholunate joint), the hand (intercarpal joints, carpometacarpal joints, metacarpophalangeal joints), the hip (femoroacetabular joint), the knee joint, the ankle joint, the foot (subtalar joints, intertarsal joints, tarsometatarsal joints).
    It is advised that you avoid heavy lifting and exercise for 2 days after the injection.

  • Ultrasound Nerve Block Injection

    Celestone chronodose (by itself or mixed with local anaesthetic) can be injected around nerves for a diagnostic or therapeutic nerve block or to treat impingement or neuritis. This can include the ulnar nerve (Guyon canal, wrist, cubital tunnel), median nerve (carpal tunnel, at the pronator teres confluence), radial nerve (wrist, elbow, posterior interosseous nerve), suprascapular nerve, brachial plexus, greater occipital nerve, ilioinguinal nerve, iliohypogastric nerve, lateral femoral cutaneous nerve of the thigh, sciatic nerve, peroneal nerve, saphenous nerve, sural nerve, posterior tibial nerve, medial or lateral plantar nerve, interdigital nerve (Morton neuroma or adventitial intermetatarsal space bursitis)

  • Ultrasound Peri Tendon Injection

    Celestone Chronodose and local anaesthetic can be injected around tendons to reduce inflammation and promote healing of tendinosis and aid pain relief in tendon tears. Sites include the rotator cuff, long head of biceps tendon at the bicipital groove, the common extensor tendon origin complex (lateral epicondylitis or Tennis elbow), the common flexor tendon origin complex (medial epicondylitis or Golfer’s elbow), triceps tendon, distal biceps tendon, De Quervain’s Tenosynovitis, intersection syndrome, A1 pulley, flexor digitorum tendons, psoas tendon, gluteal tendons, hamstring tendons, iliotibial band (proximally or distally), patella tendon, achilles tendon, tendons of the ankle and foot.
    It is advised that you avoid heavy lifting and exercise for 2 days after the injection.

  • Ultrasound Bursa Injection

    Ultrasound can be used to guide a needle into a bursa (for instance olecranon bursa, subdeltoid bursa, psoas bursa, trochanteric bursa, submaximus bursa, prepatellar bursa, iliotibial band bursa, pes anserine bursa). Then the bursa contents can be aspirated for pathological analysis, and/or steroid and local anaesthetic can be injected if indicated.
    After the injection, the bursa can feel bigger than before the injection, since it is filled with the medication. This will resolve after 1-2 days as the medication soaks in.
    The subdeltoid bursa is commonly treated with ultrasound guided injection of long acting steroid and long acting anaesthetic.

  • Ultrasound Fenestration

    Ganglion fenestration

    1. This can be part of treatment of a ganglion cyst. Most ganglion cysts have relatively thick walls. So after the fluid contents have been aspirated from the ganglion cyst, it is possible for the cyst to recur by refilling with fluid. Therefore multiple holes are made in the walls of the ganglion cyst ( ie fenestration) with a fine needle under ultrasound guidance to help prevent the recurrence of the ganglion.
    2. This can be performed at the same time as ganglion cyst aspiration or ganglion cyst steroid injection.

    Fascia or tendon fenestration

    1. This can be part of treatment of chronic fascia or tendon “inflammation” (eg plantar fasciitis, Achilles tendinosis, biceps femoris tendinosis, semimembranosus/semitendinosus tendinosis, common extensor tendon complex, common flexor tendon complex)
    2. A fine needle is passed through the structure multiple times to stimulate the healing process.
    3. This can be performed at the same time as ultrasound guided steroid/anaesthetic injection to the structure.
    4. It is advised that you avoid heavy lifting and exercise for 5 days after the injection.
  • Ultrasound Nerve Block

    Ultrasound guidance is used to identify the nerve (brachial plexus, suprascapular nerve, posterior interosseous nerve, ulnar nerve at the elbow, ulnar nerve at the wrist, median nerve at the elbow, median nerve at the wrist (carpal tunnel syndrome), ilioinguinal nerve, iliohypogastric nerve, lateral femoral cutaneous nerve of the thigh, sciatic nerve, peroneal nerve, posterior tibial nerve, digital nerve of the foot). Then ultrasound is used to guide a fine needle very close to the nerve so that local anaesthetic/steroid can be injected closely around the nerve.

    This can be part of treatment of inflammation and/or to reduce pain.

    A nerve block can be performed at the same time as an ultrasound guided injection or other ultrasound guided treatment (eg hydrodilation or calcification fenestration)

  • Plantar Fascia

    The plantar fascia extends from the tuberosity of the calcaneus to the heads of the metatarsals. It supports the plantar arch of the foot.

    Ultrasound is used to guide a fine needle onto the surface of the plantar fascia. Steroid and local anaesthetic can be injected onto the surface of the plantar fascia as treatment for inflammation.
    Other treatments that are possible with ultrasound guidance include tibial nerve block, lateral plantar nerve block, plantar fascia fenestration/dry needling, autologous blood injection to the plantar fascia.

    After the injection you may feel a lump under the foot, which is partly due to the medication sitting on the plantar fascia, before it soaks in (takes 1-2 days) and partly due to the numbness produced by the local anaesthetic (can last 3-4 hours).

    It is advised that you avoid heavy lifting and exercise for 2 days after the injection.

  • Ultrasound Peri Ligament Injection

    Ultrasound can be used to guide a fine needle very close to an inflamed ligament, so that steroid and local anaesthetic medication can be injected closely around the inflamed ligament.
    This can be part of the treatment for a chronically inflamed or chronically injured ligament (chronic ligament strain).

    You may experience some numbness due to the local anaesthetic which should resolve in 3-4 hours.

    You may notice some increased swelling around the tendon, which is merely the medication pooling around the tendon, and will resolve when the medication soaks in, in about 1-2 days.

    It is advised that you avoid heavy lifting or exercise for at least 2 days after the injection.

  • Hydrodilation

  • Hydrodissection

  • Tenocyte transplant

  • Autologous Blood Injection (ABI) / Protein Rich Plasma (PRP)

  • Brachial plexus block

  • Local anaesthetic

  • Durolane / Hyaluronic Acid injection