Ultrasound & Fluoroscopy Guided Injections

What You Need to Know

Ultrasound or fluoroscopy guided injections are injections where the drugs, in most cases steroids or local anesthetics, are administered with the guidance of medical imaging techniques. Ultrasounds provide real-time images of internal body structures such as bursae, joints, muscles, nerves or tendons; whereas fluoroscopy provides real-time images of bones. This visual guidance is used when injections need to be given at very specific locations.

Ultrasound pictures are made by using sound waves. Fluoroscopy uses a C-arm or fluoroscopy unit to generate real time images that allow injections to be performed with great accuracy and gentleness. The C-arm allows the spine to be explored. It uses X-rays to obtain images.

Ultrasound or fluoroscopy guidance allows the direct visualization of the tip of the needle in real-time as it pierces the skin and enters the target site, such as epidural space, facet joint, or knee or shoulder joints. This increases the accuracy of the injections. This is the current standard of care when performing pain injections because more precise injections are usually more effective. Without this visual guidance, injections are more prone to misplacement, potentially even occurring in the wrong region.

Ultrasound or fluoroscopy guided injections are used in the treatment of multiple pain conditions that require an injection of local anesthetics, steroids, plasma-rich platelets or stem cells. The physician numbs a small area of skin with an anesthetic. After the area is numb, the physician uses ultrasound or fluoroscopy to direct a very small needle into a joint, epidural space or facet joint.