Should you have an ultrasound-guided cortisone injection? Most cortisone injections are still done “blind”, relying on the doctor knowing the anatomy. Increasingly, doctors guide them with an ultrasound. So why have an ultrasound-guided cortisone injection, who should do it, and how much should it cost in London?
This page covers cortisone specifically. For ultrasound guidance in general, see whether an ultrasound-guided injection is better; for the wider private cortisone-cost picture, see private cortisone injection cost.
What does an ultrasound-guided cortisone injection mean?
A guided injection lets the doctor see the exact spot rather than guess. There are two ways to see the needle: X-ray or ultrasound. Which is better?
X-ray vs ultrasound for a guided cortisone injection
In most cases, ultrasound wins. It’s less expensive, uses no harmful radiation, and is done in a clinic room rather than a hospital. We once believed X-ray was more accurate, but recent studies show ultrasound is just as precise — and most patients prefer it. Even insurers such as BUPA now favour ultrasound over X-ray injections.
Advantages of an ultrasound-guided cortisone injection
- More accurate placement
- Less pain during the injection
- Improved outcomes
- Fewer side effects
- Lower risk of injecting nerves or blood vessels
Disadvantages
Ultrasound injections aren’t all upside down. They’re technically difficult — it takes years to learn to inject safely under ultrasound. They also need extra equipment (a machine, gel), which increases the risk of contamination if the technique is poor. A strict sterile technique is essential.
Which injections do we do under ultrasound?
We perform most joint and tendon injections under ultrasound guidance, though spinal injections should be performed under X-ray. Guidance Examples include the hip joint, sacroiliac joint, piriformis, knee, carpal tunnel, shoulder, plantar fascia, ankle, greater trochanteric pain syndrome, and nerve injections.
Who should perform a cortisone injection under ultrasound?
In the UK, many practitioners perform ultrasound-guided injections — specialists, general practitioners, physiotherapists, and even beauty therapists — with varying levels of skill. Specialist doctors generally get the most training. Verify your practitioner’s experience and that they use proper technique, including gloves and clean injection packs. (The four questions to ask are here.)
How much does an ultrasound-guided cortisone injection cost in London?
An ultrasound-guided cortisone injection at Chelsea costs £400, including the consultation and ultrasound as part of the one-stop visit. Other clinics cost more. Across London, private cortisone injections range widely — from about £250 to £1,000 for the same shot — and a higher price doesn’t guarantee a better result. See the full self-pay fee list here and our private cortisone cost guide for guidance on judging value.
Dr Masci’s experience
Dr Masci performs ultrasound-guided cortisone injections in London for joint and tendon conditions. With over 15 years of ultrasound experience, he teaches other doctors, performs about 500–1,000 injections a year, has developed an online ultrasound injection course, written scientific papers, and runs an advanced injection course. He speaks at international conferences, including the British Medical Ultrasound Society.
Frequently asked questions about ultrasound-guided cortisone injection
How much does an ultrasound-guided cortisone injection cost?
At Chelsea, it’s £400, including the consultation and ultrasound in a single one-stop visit. Other clinics charge more, and London prices range from roughly £250 to £1,000 — price isn’t a reliable guide to quality.
Is an ultrasound-guided cortisone injection better than a blind one?
Generally, yes — better accuracy means a better, longer-lasting effect and fewer side effects. The needle is also less likely to catch nerves or vessels.
Is ultrasound or X-ray better for cortisone?
For most joints and tendons, ultrasound is equally accurate, cheaper, radiation-free, and preferred by patients. Spine injections are the main exception, usually performed under X-ray guidance.
Does an ultrasound-guided cortisone injection hurt?
Usually, it is less than a blind injection, because the doctor avoids sensitive structures. A local anaesthetic is first used to numb the area.
Final word from Sport Doctor London about ultrasound-guided cortisone injection
Ultrasound-guided cortisone injections are better — they hit the spot, last longer, and reduce side effects. But it’s a complex skill, so see an experienced doctor for your guided cortisone injection.
To book in London, contact the team here or call +44 (0) 203 488 0350.
Thanks a lot for this article! I did not know that ultrasound guided injection was a thing. You performed it in a professional and confident way, so I might try that out!
Thanks, Fabian for your comments. I try to be as objective as possible in my blogs.