Joint inflammation is one of the most common causes of painful joints. Local anesthetics and/or corticosteroids can sometimes be injected directly into the joint to reduce inflammation and provide pain relief. This can facilitate the healing process by reducing pain.

A shoulder, knee, and hip operation is one of the most popular uses, but may also be beneficial for other joints as well. A picture is used to guide the injection needle so that it goes into the joint where it has the greatest chance of working. Ultrasound is usually used to guide the injection needle. A CT scan or an X-ray may also be used for guidance.

Referring doctors may have difficulty determining precisely what is causing joint pain. Pain symptoms may not be improved by injections if they are caused primarily by joint inflammation. Despite this being disappointing for the patient, the doctor can use this as beneficial information, since it indicates that another cause of joint pain is needed to be considered. Another more detailed imaging scan of the joints can also be used to perform a joint injection. CT or MRI imaging is usually done in this case; dye is injected into the joint for more detailed.

Why would my doctor refer me to have this procedure?

Imaging guidance may be used to guide joint injections when:

  • Despite other treatments, joint inflammation has not improved;
  • It is painful in the vicinity of the affected joint, and your doctor would like to know if the condition stems from the joint itself;
  • There must be direct injections of special medications or treatments into a joint rather than into surrounding soft tissues;
  • It may be conducted as part of a more detailed joint scan, known as an arthrogram, or it may be done separately.
  • Using imaging guidance in the consulting room has not been effective in injecting directly into the joint without your doctor’s guidance.

How do I prepare for a joint injection?

  • Before your appointment day: before getting a joint injection, nothing special needs to be done. It is okay to consume fluids and eat as usual.
  • On the day of your appointment:  If you have undergone X-rays, ultrasounds, CTs, or MRIs in the past, please bring them to your appointment. In case you have an allergy to any medication, please tell the radiologist. Having easy access to the joint that needs to be injected might be the best clothing choice.

What happens during a joint injection?

Typically, ultrasound is used to guide joint injections. In addition to X-rays and CT imaging, radiologists (medical specialists) who inject the joint can choose another method, depending on their preferences.

To determine exactly the location where the injection will be performed, a preliminary scan will be performed, which should be visible on your skin. An antiseptic solution will be applied to prevent infection of the skin.

If the tip of the needle can be seen when it enters the joint, it will be placed either at the point on your skin marked for needle placement or with the use of ultrasound to locate the spot on your skin marking the needle placement. An injection of contrast medium into the joint to ensure a clear image and properly positioned needle tip may be used if CT or X-rays are used to guide the needle.

Radiologists may remove some joint fluid before administering an injection for analysis. Steroids or local anesthetics are used as part of the injection.

Are there any after-effects of a joint injection?

After the injection, you may feel sorer in the joint, but you will likely feel better initially because of the local anesthetic. Your joint will likely feel worse after the anesthetic wears off and your pain may worsen. After the injection, you may notice soreness for two to three days.

Steroid injections are usually effective at reducing joint inflammation within 3–5 days of injection, however.

In the following days, if the pain became very severe, it could be due to the injection aggravating the synovitis or very rarely infection of the joint. This should be reported as soon as possible to your physician or to an emergency room in a hospital.

How long does a joint injection take?

While the length of time can vary depending on the plan, an ultrasound-guided injection generally takes between fifteen and thirty minutes.

What are the risks of a joint injection?

There are a few risks associated with this procedure.

As a result, there is a very small risk of infection. It may be 1 in 20,000 to 1 in 75,000 injections conducted. If the skin over the joint is broken or infected, or if it may be infected already, the procedure should be avoided.

The steroid injection could lead to complications, such as an aggravation of pain due to crystals in the solution irritating the joint lining.

The risk of minor damage to the soft tissues at the injection site arises from the steroid injection not being entirely injected into the joint or leaking out after the injection. This includes skin or subcutaneous fat atrophy (weakening). An injection site may be associated with localized depigmentation of the skin.

It is common for patients to receive pain relief with an injection for a few months, but then their pain returns and they wonder whether they need another injection. While doctors aren’t sure exactly how risky multiple injections are, studies have shown that joints aren’t damaged by injections more than three to four times each year.

The injected medication can occasionally cause an allergic reaction (as with any other medication). While it does not seem to be common, the risk seems quite low. Should you have any allergies, please inform your doctor and the radiologist who will perform the joint injection.

What are the benefits of a joint injection?

It is determined whether the injected joint has pain with joint injections, and the local inflammation of the joint is reduced to enable physical therapy to be administered without pain.

Steroid injections are believed to provide pain relief for 3 to 3 months, especially when combined with appropriate physical therapy for joints (especially the shoulder and the knee).

Pain medications may provide temporary relief, but they do not address the deeper cause of joint pain (e.g., osteoarthritis).