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Steroid Injection

A common cause of a painful joint is synovitis (inflammation of the lining of the joint). It can be useful to inject corticosteroid and/or local anaesthetic medication directly into the joint or the soft tissue next to a joint (this is often called a bursa) to reduce the inflammation and provide pain relief. Reduction in pain may make physical therapy more effective. This procedure is most often used in the shoulder, knee, or hip but may also be helpful in other joints.

To make sure the injection goes into the joint itself where it has a better chance of working, the needle for the injection is guided by ultrasound.

How do I prepare for a Steriod Injection?

Prior to your appointment: You don't need to do anything special before a joint injection. You may eat and drink as normal. 

On the day of your appointment: Please bring any previous Ultrasound, X-rays, CT or MRI scans taken as part of your joint pain history.  

Please tell the radiologist if you are allergic to any medications. 

Procedure

The Steriod Injection is most commonly performed using ultrasound to guide the injection. The exact technique varies depending on the joint to be injected and the radiologist (specialist doctor) who performs the injection. Generally a preliminary scan will be performed to locate the exact point to be injected, which may be marked on your skin. The skin will then be cleaned with an antiseptic solution to prevent infection. A needle will then be placed into the joint either at the point marked on your skin or using the ultrasound to see the tip of the needle as it moves into the joint or bursa. Sometimes the radiologist may remove some fluid from the joint for analysis before injecting usually a mix of steroid and/or local anaesthetic into the joint or bursa.

Are there any risks of a Steriod Injection?

There is a risk of infection, which is very small and probably lies between 1 in 20,000 and 1 in 75,000 injections performed. The procedure should not be performed if there is broken skin or infection overlying the joint, or if the joint may already be infected.

There are possible complications of the steroid injection, which include aggravation of the pain due to irritation of the joint lining by crystals in the steroid solution.

If the steroid is not injected solely into the joint, there is a risk of damage to the soft tissues at the injection site, including atrophy (a weakening) of the skin or subcutaneous fat (found just beneath the skin) and rupture of the tendons around the joint. Some patients find that the injection gives them good pain relief for a few months, but then the pain comes back and they wonder about having another injection. Although the exact risk of multiple injections is not known, most doctors would advise against injection more than 3-4 times a year to avoid damage to the joint. Occasionally people are allergic to the injected medication (as with any drug). The exact risk of this is not known but it seems to be very uncommon. You should advise your doctor and the radiologist performing the Joint Injection of any allergies you may have.

 

 

 

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