Ultrasound-guided Joint Injections

At Parkview Orthopaedic Group, our physicians offer patients many conservative treatment options—joint injections are one of the most common choices. Injections can be used to treat pain in most areas of the body, and many patients experience significant relief from them. We offer both cortisone (steroid) injections and viscosupplementation (“gel” injections).

Ultrasound-guidance

To make sure the injections are as effective as possible, many of our physicians use point-of-care ultrasound, also known as bedside or portable ultrasound. It is the same technology as you may be familiar with to look at babies in the womb, but we use the safe, non-invasive technology to view the internal anatomy like joints, muscles, tendons, bones and tissue. And because of its portability, our physicians can use the ultrasound machine right in the exam room. The ultrasound helps our physicians to correctly place the needle, ensuring that the medication is injected exactly where it will be most effective. The use of ultrasound-guided injections has also been shown to diminish the discomfort associated with these injections.

Cortisone (Steroid) injections

Steroid injections can be used to relieve pain in many parts of the body—most commonly the hip, knee, shoulder, hands and feet. Though cortisone is not a pain reliever itself, it works by reducing inflammation and swelling in affected muscles, joints, tendons or bursa—relieving the discomfort caused by such inflammation. It is typically administered in one single injection and can be repeated again after several months. (The length of time required between injections varies by physician, so please discuss with him or her.) The effects of the injection are usually felt quickly and can last for months, though the benefits do vary for every patient and every problem. Cortisone injections may be used to treat a wide variety of conditions, including:

• Osteoarthritis of the shoulder, elbow, wrist, fingers, knee, ankle and foot
• Bursitis of the hip, knee, elbow, or shoulder
• Tendonitis such as tennis elbow or rotator cuff tendonitis
• Plantar fasciitis
• Trigger fingers
• Carpal tunnel syndrome

Viscosupplementation (“Gel” injections)

“Gel” injections are used primarily to treat arthritis of the knee. The “gel” that is injected is actually hyaluronic acid, which provides the knee with lubrication that acts as a shock absorber. This cushions the knee joint and can improve the pain that is caused from osteoarthritis. Think of it much like motor oil that lubricates a car engine – it reduces friction and helps things move more smoothly. When the thick viscous gel is injected into the knee, it can relieve the pain of osteoarthritis without surgery and help one lead a more active lifestyle with increased mobility.

The medication is most commonly administered in a series of injections, one week apart for three or four consecutive weeks. Viscosupplementation is well tolerated and is often recommended for patients who have failed to respond to other conservative treatment options, such as over-the-counter pain medications, weight loss, and even prescription arthritis medications. Side effects are generally minimal and can include some pain and swelling. Furthermore, gel injections can offer pain relief while avoiding the side effects of traditional anti-inflammatory medications, such as stomach, kidney, and liver problems. The degree of success varies widely between patients—some experience substantial pain relief, while it is minimal for others. Discuss with your Parkview physician whether or not you are a candidate for this treatment option.