Ultrasound-Guided Injection

Homeopathic Injection

Homeopathic Injections can be beneficial for both the diagnostic and therapeutic treatment of a variety of problems involving the hip, shoulder, and knee.  Ultrasound-Guided Injections allow the practitioner to visualize the needle in real-time as it enters the body and traverses to the desired location.  This greatly increases accuracy compared to blinded injection.

Ultrasound is beneficial when performing injections in the knee, shoulder, and hip; as well as many other structures throughout the body.

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. Fluoroscopy (a type of real-time X-ray) allows the 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 us to visualize the bony joint as well as all of the surrounding structures. Moving the ultrasound probe the practitioner 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 without the associated radiation.

Ultrasound is beneficial when performing injections in the knee, shoulder, and hip; as well as many other structures throughout the body.

Hip

Hip joint injections may be performed for osteoarthritis of the hip and the diagnosis and management of labral tears. Imaging is nearly always used when performing injections into the hip joint due to the deep location of the joint and the proximity of blood vessels and nerves. It is estimated that blind injections are accurate 50% to 80% of the time. Ultrasound allows us to visualize the hip joint, bursa, muscles, and tendons surrounding the hip. The use of ultrasound when performing a hip injection increases the accuracy to up to 96%. Whereas in the past, hip injections were mainly performed using Fluoroscopy, ultrasound-guided injections have become more popular due to its ease of use, lower cost and ease of perform in the office setting.

Shoulder

Studies have shown that Ultrasound of the shoulder is just as sensitive and specific as MRI in the diagnosis of rotator cuff injury. Ultrasound can facilitate the more accurate injection of multiple different structures in the shoulder including the Acromioclavicular (AC) joint, the Glenohumeral joint (the true shoulder joint), the biceps tendon, and the subacromial bursa. All of these can be injected with or without guidance, however, as noted above the accuracy of these injections is significantly improved with the use of ultrasound guidance.

Knee

Ultrasound can help evaluate a variety of structures within the knee including the quadriceps and patellar tendons, the extra-articular (outside the joint) ligaments, and some meniscus injuries. It can also be used to see if there is fluid within the knee joint. Although knee injections are typically performed without imaging, imaging can be particularly helpful in patients with difficult anatomy or in overweight patients.