Ultrasound Guided Joint Injections

Ultrasound-Guided Injections for Joint and Soft Tissue Pain Relief

Ultrasound-guided injections are a modern, minimally invasive approach to managing joint and soft tissue pain. By using real-time imaging, clinicians are able to visualise the affected area with remarkable precision, ensuring that therapeutic agents are accurately delivered to the exact site of injury or inflammation. This level of accuracy significantly improves patient outcomes by enhancing the effectiveness of treatment while minimising potential complications such as bleeding, infection, or injury to adjacent structures.

Why Use Ultrasound Guidance?

Ultrasound guidance offers several clinical advantages over traditional “blind” injection techniques. Without imaging, clinicians must rely on anatomical landmarks and palpation, which can result in variable injection placement—especially in deeper or anatomically complex joints such as the hip or shoulder. Real-time ultrasound ensures that the needle is placed precisely where it is needed, reducing the risk of misplacement and increasing the efficacy of the injected medication.

In addition, ultrasound imaging allows the clinician to visualise sensitive structures such as nerves, blood vessels, and tendons, making it easier to avoid them and reduce patient discomfort. Many patients report that ultrasound-guided injections are more tolerable and result in quicker relief compared to traditional techniques.

Hydrocortisone Injections

One of the most common medications used in ultrasound-guided injections is hydrocortisone, a potent corticosteroid known for its anti-inflammatory effects. Hydrocortisone injections are widely used to treat pain and inflammation caused by a variety of musculoskeletal conditions, including arthritis, bursitis, tendonitis, and post-traumatic joint swelling.

Typical target joints include the:

• Shoulder

• Elbow

• Wrist and hand

• Knee

• Hip

• Ankle and foot

The benefits of corticosteroid injections are usually felt within a few days, providing relief that can last from several weeks to a few months. However, hydrocortisone is not a long-term solution. Emerging research, including data from orthopedic specialists and studies referenced by Arthrex and the American Academy of Orthopaedic Surgeons (AAOS), suggests that repeated corticosteroid injections—especially into the knee—may have a degenerative effect on joint cartilage over time. For this reason, their use is often limited to a few injections per year, and alternative regenerative therapies are gaining popularity.

Regenerative Alternatives: Hyaluronic Acid and Platelet-Rich Plasma (PRP)

As understanding of joint preservation has evolved, hyaluronic acid (HA) and platelet-rich plasma (PRP) therapies have emerged as viable alternatives to steroid injections, especially in patients with degenerative joint disease or chronic tendinopathies.

Hyaluronic Acid (HA) is a naturally occurring substance found in joint fluid that provides lubrication and shock absorption. In conditions like osteoarthritis, HA breaks down, leading to joint stiffness and pain. HA injections help restore this lost viscosity, improve mobility, and reduce discomfort. These injections are particularly beneficial for patients with mild to moderate knee osteoarthritis.

Platelet-Rich Plasma (PRP) therapy represents a significant advancement in biologic treatment for joint and tendon conditions. PRP is derived from the patient’s own blood and contains a high concentration of platelets, growth factors, and cytokines that promote healing and tissue regeneration. According to studies published in the Journal of Orthopaedic Research and validated by Arthrex’s clinical findings, PRP has shown strong evidence in treating:

• Knee osteoarthritis

• Lateral and medial epicondylitis (tennis and golfer’s elbow)

• Rotator cuff injuries

• Patellar tendinopathy

• Postoperative wound healing

At our clinic, we utilise an Arthrex ACP (Autologous Conditioned Plasma) centrifuge system, ensuring a consistent and high-quality PRP preparation. This method yields a concentrated PRP solution that is both safe and effective. We recommend a course of three injections spaced one week apart for optimal results. Patients often begin to notice improvement within 2–6 weeks, and benefits may last for 6 to 12+ months depending on the condition being treated.

Common Conditions Treated with Ultrasound-Guided Injections

Ultrasound-guided injections are highly versatile and can be used to manage a wide array of orthopedic conditions, including:

• Frozen Shoulder (Adhesive Capsulitis) – hydrocortisone and/or PRP can reduce inflammation and improve range of motion.

• Subacromial Impingement Syndrome – steroid injections reduce inflammation in the subacromial bursa.

• Acromioclavicular Joint Pain – precise steroid or PRP delivery helps relieve pain in this small but frequently affected joint.

• Tennis Elbow (Lateral Epicondylitis) – PRP injections support tendon healing and have demonstrated superior outcomes over corticosteroids in long-term studies.

• Golfer’s Elbow (Medial Epicondylitis) – similar to tennis elbow but affecting the inner elbow.

• Carpal Tunnel Syndrome – guided injections reduce swelling around the median nerve.

• De Quervain’s Tenosynovitis – inflammation in the wrist’s tendons is targeted for pain relief.

• Trochanteric Bursitis – common in runners and older adults; ultrasound ensures accurate delivery into the bursa.

• Osteoarthritis of the Knee – PRP and HA injections provide a non-surgical solution for pain and function.

• Morton’s Neuroma – targeted injections reduce nerve pain in the forefoot.

• Plantar Fasciitis – PRP or steroid injections relieve inflammation and support recovery.

• Osteoarthritis of the Ankle – both PRP and HA are used for pain relief and mobility improvement.

Referral and Access

We accept referrals from GPs, physiotherapists, and other healthcare professionals, provided a clear diagnosis has been made. To facilitate continuity of care and optimal outcomes, please send referrals to: Reception@aranleighhealthcentre.com.

Each referral will be assessed individually, and a treatment plan tailored to the patient’s condition will be developed in collaboration with the referring clinician. Where necessary, additional diagnostic imaging (MRI or X-ray) may be requested to confirm the suitability of injection therapy.