Ultrasound Guided Injection: Improving Accuracy for Better Results

Injections are essential in treating joints and tendons. Common injections include cortisone, hyaluronic acid, and platelet-rich plasma. We think hitting the target is critical to getting a good effect. Unfortunately, hitting a target is easier than it seems. Therefore, we use an ultrasound-guided injection to improve our hit rate. We have outlined the top four questions if you are thinking of having an ultrasound-guided injection. 

Why have an ultrasound-guided injection?    

Traditionally, doctors do injections ‘blind,’ meaning the practitioner needs to know the anatomy to hit the spot. However, even with experience, getting to the right place is challenging. Studies suggest striking the right site is as good as flipping a coin. Recently, doctors have been using ultrasound to improve their hit rate. 

Overall, we know that US-guided injections are more accurate. Also, an improved hit rate means the effect is better and lasts longer. A recent study shows that a hyaluronic acid injection performed with ultrasound has a much better impact than blind injections. Patients who had ultrasound hyaluronic acid injections for knee arthritis had much lower rates of knee replacement than those who had blind injections. 

How do we perform an ultrasound-guided injection? 

Generally, an ultrasound-guided injection is performed much the same as traditional injections. However, the critical difference is that the needle and target are visualised during the injection. 

Firstly, we apply ultrasound gel directly onto the skin. This gel allows the ultrasound sound waves to pass through the skin. Once the ultrasound sees the anatomy, we use a needle to target the joint or tendon. The key is seeing the injection flow through the needle into the target.

Who performs ultrasound-guided injections in the United Kingdom?  

An ultrasound-guided injection is complex and requires many years of training. This training generally takes many years, and skill levels are only obtained through years of training.  

In the United Kingdom, many different practitioners perform ultrasound-guided steroid injections. These groups include specialists, general doctors, physiotherapists, podiatrists, and beauty therapists. Overall, doctors have the most experience and training in ultrasound-guided injections. Other groups, such as physiotherapists and podiatrists, have less training. 

What should you check before you have ultrasound-guided cortisone injections?

Given the differences in skill levels among groups, it makes sense to ask questions. These are the top four questions to ask before you have a US-guided injection.

1. Is your doctor skilled in ultrasound-guided injections?

Generally, we recommend seeing a doctor with experience in ultrasound. A specialist doctor is better, although some general doctors have good ultrasound injection experience. Physiotherapists and podiatrists have less training than doctors. 

2. Does your doctor take pictures of the injection?