Ultrasound Guided Injections
Ultrasound, also known as sonography, is an imaging method that uses high-frequency sound waves to produce real-time and dynamic images of the body. At Aptiva Health, our healthcare providers utilize ultrasound to view the structures beneath the skin to confirm optimal needle placement so the medication in the injection reaches the exact targeted area. In the past, healthcare providers have utilized a blind technique, which is based on musculoskeletal landmarks rather than a method of direct visualization, which is achievable with ultrasound.
Ultrasound-guided injections allow the healthcare provider to visualize the needle in real time as it enters the body and reaches the desired location. The use of ultrasound assures that the medication is accurately injected at the intended site. Despite good intentions, even in the most experienced hands, blind (injections performed without imaging) injections are not 100% accurate and in some joints accuracy is as low as 30%-40%. With ultrasound guidance the accuracy of nearly every joint injection exceeds 90% and approaches 100%.
Additionally, ultrasound guided injections have been shown to be less painful than blind injections. Ultrasound injections also have the advantage of giving “real time” and “dynamic” feedback that the patient and the doctor can see and use immediately. The doctor is able to watch the desired treatment being delivered to the intended target and even visualize surrounding structures both before during and even after the procedure.
At Aptiva Health, we offer same-day and walk-in appointments for joint injuries and conditions to evaluate, diagnose, and make the appropriate referral for additional treatment based upon your specific joint injury or condition. We treat these conditions in our General Medicine, Orthopedics, Sports Medicine, Pain Management, and Physical Therapy departments.
Advantages of Ultrasound
Although there are many different types of imaging that can be used to assist with injections, ultrasound has a few distinct advantages.
1) Ultrasound has no radiation. Flouoroscopy (a type of real time X-ray) allows the healthcare provider to easily visualize the joint making injections easier, however, fluoroscopy is associated with repeated doses of radiation. Additionally with fluoroscopy the providers are unable to visualize surrounding soft tissue structures including tendon, blood vessels or nerves that may be in the path of the needle. This could lead to increased pain or other complications from the injection.
2) Ultrasound allows healthcare providers to visualize the bony joint as well as the surrounding structures. Moving the ultrasound probe the provider can visualize what may be in the path of the needle and avoid any unwanted complications before they happen.
3) Ultrasound is able to identify fluid better than conventional radiographs and can see fluid that may have accumulated in and around joints, tendons, muscles, nerves and other soft-tissue structures. CT-guided (or CAT Scan) injections are also frequently used to assist in delivering treatments. With the CT we are able to get a 3-D view of the joint to be injected and can accurately deliver the intended medication, however, these tests come with an increasingly large dose of radiation, they are expensive and time-consuming. Ultrasound injections have been shown to be as accurate as these other imaging-modalities with less cost, improved soft tissue visualization and does not expose the patient to unnecessary doses of radiation.
Types of Ultrasound Injections
At Aptiva Health, our healthcare providers perform ultrasound guided injections with a variety of medications in several joints. Most commonly, ultrasound guided injections are performed in small, medium, and large joints.
These include:
Finger joints
Wrists
Elbows
Shoulders
Hips
Knees
Ankles
Toes
Common medications or types of injections that are performed by ultrasound guidance include:
Corticosteroid injections: cortisone or steroid shots are injections that help to relieve pain and inflammation in a small area in the body, such as a specific joint or tendon. This type of injection offers quick relief for inflammation and is most commonly used in the wrist, spine, shoulder, knee, hip, elbow or ankle.
PRP injections: PRP therapy uses injections of a patient’s own platelets to accelerate the healing of injured joints, tendons and soft tissues. Specific conditions that can be treated with PRP include:
Osteoarthritis
Tendonitis/chronic tendon injuries
Back and spine conditions
Nerve damage and injury
Ligament and muscle injuries
Non-healing wounds
Stem cell therapy: stem cell injections use a patient’s own stem cells to treat osteoarthritis and soft tissue injuries. Regenerative stem cells are harvested from a patient’s bone marrow in the pelvis or hip bone. These cells can help rebuild soft tissue, cartilage and bone, making them an excellent resource for speeding up the healing process and improving overall function.
Viscosupplementation injections: contain hyaluronic acid, a lubricating gel-like fluid. The injection goes directly into the joint, decreasing friction during movement and reducing pain associated with osteoarthritis while improving the range of motion of the joint.