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Joint Injections

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Joint steroid injections are a conservative treatment option for joint pain. They can be used to treat pain after a course of medications, or before physical therapy is completed, and possibly before surgery is considered. These injections can be useful in providing palliative pain relief and as a diagnostic tool to help in identifying the source of the pain. The goal is to reduce or alleviate the pain.

The procedure is most often used in the following joints:

  • shoulder
  • wrist
  • hip
  • knee
  • ankle

Will this work if oral pain medications do not?

Injections can be more effective than an oral medication because they deliver medication directly to the anatomic location that is generating the pain. A long acting anesthetic and steroid medication is injected to deliver a powerful anti-inflamatory solution directly to the area that is believed to be the source of pain. Depending on the type of injection, some forms of pain relief may be long lasting while some may only be temporary.

Who will perform this procedure?

A radiologist will explain and answer questions before the procedure and then will perform the procedure. Expect to be at our facility 45 minutes to 1 hour.

When can I resume normal activities?

Normal activity can resume as soon as tolerated.

MR Arthrography Injections

MR arthrography involves the injection of contrast material into a joint prior to an MRI examination. The contrast material outlines the structures within the joint, helping the radiologist evaluate the anatomy of the joint.

What are some common uses of the procedure?

Arthrographic images help physicians evaluate alterations in structure and function of a joint and help to determine the possible need for treatment, including surgery or joint replacement.

The procedure is most often used to identify abnormalities within the:

  • shoulder
  • wrist
  • hip
  • knee
  • ankle

The procedure is also used to help diagnose persistent, unexplained joint pain or discomfort.

How should I prepare?

No special preparation is necessary before arthrography. Food and fluid intake do not need to be restricted.

You should inform your physician of any medications you are taking and if you have any allergies, especially to contrast materials. The radiologist should also know if you have any serious health problems or if you have recently had surgery. Some conditions, such as severe kidney disease, may prevent you from being given contrast material for having an MRI.

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI scanning area unless explicitly instructed to do so by a radiologist or technologist who is aware of the presence of any of the following:

  • internal (implanted) defibrillator or pacemaker
  • cochlear (ear) implant
  • some types of clips used on brain aneurysms

What does the equipment look like?

The equipment typically used for joint injections consists of a radiographic table, an x-ray tube and a television-like monitor that is located in the examining room or in a nearby room. When used for viewing images in real time (called fluoroscopy), the image intensifier (which converts x-rays into a video image) is suspended over a table on which the patient lies. When used for taking still pictures, the image is captured either electronically or on film.

Other equipment necessary for performing arthrography include a variety of needles, syringes and a water-soluble contrast material.

How is the procedure performed?

This examination is usually done on an outpatient basis.

The patient is positioned on the examination table and x-rays are taken of the joint to be compared later with the arthrograms.

Next, the skin around the joint is cleansed with antiseptic and a local anesthetic is injected into the area.

The area where the needle is to be inserted will be sterilized and covered with a surgical drape.

A needle is then inserted into the joint space. The radiologist, a physician specifically trained to supervise and interpret radiology examinations, will use a syringe to drain the joint fluid, which may be sent to a laboratory for analysis.

The contrast material and sometimes air are injected into the joint space and the needle is removed. The patient will be asked to move the affected joint to distribute the contrast material throughout the space.

After the injection, you will be escorted to the MRI scanner.