Osteoarthritis – or “wear and tear” arthritis occurs in all the major joints in your body. That’s the hip, shoulder, knee ankle etc. As you age, a general breakdown of the cartilage can cause pain and discomfort that becomes chronic. In fact, it is estimated that between one third and two-thirds of the population suffer from chronic pain. The pain can be incredibly painful and often doesn’t respond to Ibuprofen or Aspirin. With a rising reluctance to prescribe opioids following the opioid epidemic, many clinicians are turning to joint injections which have a mixture of anesthetic and corticosteroid in to relieve the pain. But identifying the joint and placing the needle in the correct spot can be a challenge. With new ultrasound techniques, researchers have found a more precise way of performing these crucial injections

What Are Ultrasound Guided Joint injections?

In the office, Doctors would often just identify the joint by prodding the bones in the surrounding areas. Doctors will identify bony landmarks and these would help them know where to put the needle. The problem with this is there is no guarantee that you are actually in the joint. They may be injecting the fluid into the tendons and ligaments surrounding the joint. This will help somewhat as the anesthetic and corticosteroid find its way into the joint but it is not as effective as a direct hit.

For years this was mitigated by usual fluoroscopy whereby an x-ray device and contrast dye are used to identify the joint. The issue is this requires a trained radiologist to do and you are exposed to potentially harmful radiation!

Enter ultrasound (you’ll probably know this technique from its use in pregnancy to visualize the fetus). Ultrasound guidance can be done without a radiologist and much faster. A jelly is applied and the probe is used to visualize the joint capsule. The physicians performing the procedure will be able to see exactly where the needle is and thus correctly identify if they are within the joint to inject the fluid.

What joints can it be used with?

Usually, the technique is used with the big joints in the body. Namely the

• Knees
• Shoulders
• Hips

Researchers Give the technique the thumbs up

Until very recently this technique was experimental. Many pioneers doctors swore by it for hip injections etc but there was little evidence to suggest it was as effective as fluoroscopy guided injections. A new study published recently puts any debate on this topic to rest. Researchers found that:

“These findings indicate ultrasound-guided intra-articular hip injections performed in the orthopedic clinic by surgeons or physician assistants are accurate, efficient, and patient-friendly.”

Fantastic news for anybody suffering from chronic joint pain – either from afflictions like arthritis – or from sports injuries or other, rarer, medical conditions. It means that injections are simpler to perform and are associated with fewer risks. The simplicity means physicians assistants can perform them – ensuring a lower medical bill for the patient.