Ultrasound Guided Injection

Most patients can have an ultrasound guided injection, however there are some contra-indications. It is therefore essential to notify the Doctor administering your injection in advance if you are taking any anticoagulant medication such as the ones listed below, as they could result in increased bleeding and may need to be stopped a few days before the procedure. If your anticoagulant needs to be stopped, you will need to discuss this decision with your own GP.

• Warfarin
  
• Aspirin
  
• Clopidogrel (Plavix)
  
• Rivaroxaban

The drugs we use are lidocaine (local anaesthetic) and depomedrone (steroids). If you have any allergies to these substances, you need to discuss this with our clinician.

If you currently have any type of infection, the injection will need to be delayed until you recover.

Other important things you should know:

• Diabetic patients should monitor their blood for a few days after an injection as the steroid injection can alter the blood sugar levels.
  
• There is a very small risk of infection or bruising from the injection.
  
• There is also a possibility that female patients may notice an irregularity in their menstrual cycle for a few months following a steroid injection.
  
• There is a very small risk of a lightening of the skin and/or a skin dimple (loss of fat tissue).
  
• Some patients may experience facial flushing after an injection. The onset is usually within a few hours of having the injection and can last for a few days. It affects more women than men.
  

You will need to be referred for a guided injection by a suitably qualified healthcare clinician such as a GP, sports physician, chiropractor, osteopath, physiotherapist, podiatrist etc. Once the referral form has been received at the WIOC, the referring clinician should advise the patient to call the clinic on 01443 483555 to schedule an appointment.

On arrival you should report to the clinic reception by calling 01443 483555. If you have travelled by personal transport you should remain in your vehicle and notify the reception staff of the parking bay number, if you have travelled by public transport or on foot you should follow the instructions on the patient information banner in the entrance foyer of the clinic. The reception staff will arrange for you to be triaged prior to entering the clinic, and escorted to the relevant waiting room where you will wait alone until you are collected by the sonographer.

The procedure will take place in our ultrasound suite on the upper floor of the WIOC clinic. If you have any mobility problems please let the reception staff know when you report to the desk on arrival at the clinic. There is a lift available to take you to the first floor.

It will be a qualified medical doctor who will be giving you the injection. He is trained in musculoskeletal ultrasound, and therefore qualified to interpret the images as well as administer the injection.

After the procedure has been explained to you and you have had the opportunity to ask any questions you may have, you will be asked to lie on the scanning couch or sit in a chair. You will receive a short ultrasound scan to identify the site for injection. Your skin will be cleaned using a sterile solution before the needle is inserted. The whole procedure should not take more than 30 minutes.

It is likely the pain may increase for a day or two following the injection, however you should be able to manage the pain with over the counter painkillers.

You will need to wait in the clinic waiting room for a short period to ensure there are no immediate complications, these are extremely rare and you should be fine to drive afterwards.

You may experience some post treatment soreness for a few days, however this should subside. If the area becomes swollen or red, difficult to move, or you develop a high temperature you should contact the WIOC for advice, visit your own GP or local A and E Department as they need to eliminate any infection.

You can contact us at any time via the WIOC reception staff, who will take a message and ask the relevant staff member to call you. They can be contacted by telephone on 01443 483555 or through a generic e-mail address wioc@southwales.ac.uk

You will be asked to pay for the procedure before you leave the WIOC. Payment can be made by debit or credit card.