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What is an ultrasound?

An ultrasound is a common imaging technique that employs high-frequency sound waves to create images of organs and other internal structures of the body. These images provide valuable information about the underlying pathology of tissues and assists with diagnosis and planning the treatment of a condition. The ultrasound provides a clear view of organs, tendons, muscles and joints, and any associated disorders. 

What is an Ultrasound-guided Injection? 

An ultrasound-guided injection is a minimally invasive procedure used for: 

  • Treating various painful musculoskeletal conditions such as tendonitis, bursitis, and neuritis 
  • Performing cyst aspiration 
  • Guiding the placement of needles for both diagnostic as well as therapeutic purposes

Injection of pain medication in combination with a local anesthetic directly to the site of injury helps to relieve pain. The advanced imaging of the ultrasound provides high-resolution images that enable your physician to precisely locate the injections deep into the target tissue without harming surrounding tissues.

Indications of Ultrasound-guided Shoulder Injections

The procedure is used for diagnostic as well as therapeutic purposes. Anti-inflammatory medications, such as corticosteroids and hyaluronans, are the most commonly used medications to relieve pain, inflammation, and swelling, or stimulate synovial fluid production to improve lubrication.

Shoulder joint injections are commonly used for certain conditions such as osteoarthritis, frozen shoulder, or tendonitis. The administration of the injection to the shoulder joint depends upon the condition to be treated. The approach for the application of the injection may be an anterior, posterior, superior, or inferior aspect of the joint. 

The indications for the diagnostic ultrasound imaging technique include the following:

  • Diagnose conditions such as tendon/ligament tears, inflamed bursa, joint fluid, and cysts
  • Assess painful pops and snaps that occur during movement
  • Deliver diagnostic injections to specific targets including joints, tendon sheaths, or bursa
  • Help guide needle placement during needle aspirations or injections for patients with challenging anatomical variations or people taking blood-thinning medications
  • Aspiration of a ganglion cyst
  • Guide needles in percutaneous therapy for the treatment of calcific tendonitis

Shoulder Joint Injection Technique

During an ultrasound-guided injection, you will lie or sit down on a table, depending on the site of the injection. A clear water-based conducting gel is applied over the skin to assist with the transmission of the sound waves. Your doctor moves a hand-held probe, called a transducer, over the targeted area. The transducer emits sound waves and detects the rebound echoes from the tissue. Real-time images are created from these sound waves and can be viewed on the video display screen attached to the scanner. The waves provide a clear view of the targeted area and help your doctor locate the correct site for injection. 
The path the needle takes can be viewed by the images created by the ultrasound, which guides your doctor to accurately target the problem area. The medication is then injected.

Advantages of Ultrasound-guided Shoulder Injections

The advantages of ultrasound imaging compared to other imaging techniques include the following:

  • No exposure to ionizing radiation
  • Able to assess tendons, ligaments, and muscles under high resolution
  • Provides direct visualization of the area being treated
  • Ensures accurate placement of the needle at the targeted area