Ultrasound Guided Treatments

We offer a range of ultrasound-guide injection therapy for conditions including inflammation of soft tissues and joints as seen in arthritis and tendinopathy. Still, we can also use ultrasound to assist with the drainage of fluid from cysts or haematomas caused by injury, for example.

 

We can offer several types of therapy, depending on what your referring clinician and our specialists deem most appropriate for your complaint. Ideally, all conservative measures of treatment should have been trialled prior to choosing an injection therapy.

 

At any point during the consultation with the radiologist, the patient may request the procedure not go ahead or be abandoned.

 

All procedures can be performed in a clinic setting with appointment times ranging from 10 to 30 minutes on average.

 

These include:

 

Corticosteroid injections – these are a commonly used therapy for multiple conditions including inflammation and osteoarthritis, in addition to bursitis and other causes of soft tissue inflammation such as tenosynovitis.

 

Hyaluronic acid preparations – these products are commonly used in cases of arthritis when the symptoms are troublesome but the patient’s condition does not warrant surgery or surgery is unavailable. The fluid injected acts as a lubricant for the joints, easing symptoms of pain and discomfort very successfully for the majority of patients. We are approved providers of Durolane, Cingal, and Ostenil. Some of these preparations also include corticosteroid, which can ease symptoms and inflammation further. Additionally, some brands can be used with platelet-rich plasma (PRP). These can be offered as a single injection or a course of 2-3 injections over several weeks, depending on the indication.

 

Platelet-rich plasma (PRP) – this technique involves withdrawing blood from the patient and then spinning it in a centrifuge for several minutes until the components within the blood separate into different layers. The resulting PRP layer containing a high volume of platelets and natural substances produced by the body that promote healing can then selectively be injected back into the patient’s site of symptoms in high concentrations. This technique is becoming increasingly popular for tendinopathies and arthritis as the evidence for its usage improves, but it has also been used for muscle and tendon injuries. PRP injection is a highly specialised procedure and should only be requested by specialist clinicians who are familiar with its benefits and are certain it is the most appropriate procedure for you.  This can be performed as a single injection or as a course of 2-3 injections over 4-12 weeks depending on the condition and indication.

 

Dry needling - This treatment does not rely on medication to achieve symptom relief but instead the body’s own reparative abilities. The procedure involves directing a needle into the symptomatic area multiple times causing a localised reaction and the healing process to “re-boot”. It is most commonly used in chronic conditions, where the healing process has often failed repeatedly. This is frequently used for soft tissue pathologies such as tendinopathy or tendon injury and plantar fasciitis.

 

Hydrodilatation of the shoulder - This procedure is specifically used to treat frozen shoulder (adhesive capsulitis) in which the shoulder joint capsule becomes thickened and inflamed leading to stiffness, pain, and reduced range of motion. The purpose of the procedure is to dilate the joint capsule with fluid containing anaesthetic, corticosteroid, and saline to improve flexibility and reduce inflammation and pain. The results are often immediate but ongoing success does depend on continuing physiotherapy-guided exercises.

 

Hydrodilatation of the Achilles tendon - We can perform this procedure for cases of chronic Achilles tendinopathy. Approximately 20-30mL of fluid containing anaesthetic and saline is injected around the tendon, to improve pain and movement. This will often be requested by a specialist in foot and ankle surgery or a podiatrist when conservative management has failed.

 

Prolotherapy - This is a less commonly used technique of injecting high-concentration dextrose solution into a soft tissue abnormality, often a ligament tear, in order to promote a healing reaction. This should be directed by a specialist clinician who is familiar with the indications for this treatment.