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What does an ultrasound-guided injection mean?


Ultrasound-guided injection means that we combine the benefits with  ultrasound diagnostics  and injections. Once we have identified the affected area with the ultrasound, we enter with the needle. In real time, we can then see the needle and guide it into the right area before the preparation is injected. We verify the position of the injection needle with a saved image.

Physiotherapist giving injections?

Traditionally, doctors inject. In this case, it is the ultrasound knowledge that is important, not the profession of the person in question. Being able to understand and interpret which structures we see is crucial for a safe and accurate injection. Both Stefan and Ricardo, who carry this out with us, have a degree in diagnostic ultrasound. Further training in ultrasound-guided injections has since been carried out in England. They both have many years of experience in both ultrasound diagnostics and ultrasound-guided injections.


Why ultrasound-guided injection?


Traditionally, injections are given without being able to verify if, or how much of the preparation has ended up in the intended place. With the help of the ultrasound, we see where the needle tip is and can make sure that it is in the right place, before the medicine is delivered. In other words, we can make injections with clearly greater precision than is possible without guidance with ultrasound diagnostics. In this way, the risk of affecting / damaging surrounding structures is minimized.


What types of injections do we perform?


The injections we perform are performed for diagnostic or therapeutic reasons. If there is an uncertainty about what structure it is that causes pain, then Lidocaine (pain relief) can be injected into the suspected structure. If the pain decreases, the probability is high that we have found the right one and can initiate appropriate treatment. Ultrasound-guided syringes are also used for treatment purposes. Then it is cortisone in combination with pain relief that is injected to relieve pain and lift an inflammation. 

In which diagnoses are ultrasound-guided injections used?


-Bursitis: Irritated mucous sacs (bursa) in, for example, the shoulder, elbow, outside the hip, knee or at the heel tendon.

-Lime precipitation in tendons: The most common is what is called a calcium axis.

-Capsulite: The most common location is the shoulder joint and is also called frozen shoulder. Capsulite can also be obtained in most other joints.

-We can also, with the guidance of ultrasound diagnostics, remove synovial fluid from a swollen joint (aspirate the joint), for example the knee.


When do we recommend injection?


If the pain is marked for the patient and we can state that it most likely comes from an injectable structure, then we can put an injection in an initial stage of a contact.

It is more common, however, for the patient to have undergone treatment, but the problems remain. The patient then comes to us for an ultrasound diagnosis and a decision on a possible injection. Symptoms, history and report from treating caregivers are then weighed together with findings made with ultrasound diagnostics before an injection is performed. 

Side effects that can occur with cortisone injection:


-About 25% get a reaction to the cortisone which gives a harmless, local pain in the injected area that lasts for around 48 hours.

-If you have a darker skin tone, there is a risk that the cortisone causes a change in skin color in the injection area. To minimize the risk of this, we change the needle we pull up the preparation with to a new one before the injection.

-If the patient has diabetes, the cortisone can affect the blood sugar balance for a couple of weeks.

-As soon as you get through the skin in some way, for example during injections, there is a risk of infection. With the procedure we use before and during the injection, the risk of infection is about 1 in 10,000 injections.

Physiotherapy at Alta Vita Physiotherapy

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