Imaging Guided, Non-Joint Steroid Injection
Your doctor has recommended an imaging guided corticosteroid (steroid hormone)
injection. Some “Trigger point” injections can be performed in your doctor’s office.
However, utilizing ultrasound, computed tomography (CT scan), or fluoroscopy (x-ray)
guidance can allow accurate placement of the injection, which usually leads to better
results. Inflamed tendon(s) with calcifications (calcified deposits) are the most common
ultrasound guided procedures. In some cases, the calcification can be removed at the
time of the steroid injection. Injection of various joints can be performed under CT
guidance or fluoroscopy.
What to Expect
To reduce pain and swelling after leaving the office, a cold pack/ice can be applied to
the injection site (for no longer than 15 minutes at a time, once or twice per hour).
Tylenol and non-steroidal anti-inflammatory agents such as Advil may be used,
especially for the first 24 to 48 hours. Other pain medication should be under the
supervision of your doctor. Avoid high levels of activity for several days after the
injection.
Since numbing medicine is used to perform the injection and mixed with the steroid,
many patients have pain relief following the procedure. The numbing medication will
wear off in about 2-3 hours at which time the original pain can return. If the pain returns,
it will usually begin to fade the day following the exam with continued improvement over
the next 72 hours as the steroid medication takes effect. It may take up to a week to feel
pain relief. Occasionally, a repeat injection may be necessary if the initial injection does
not relieve the pain. Also, with some calcifications and inflamed tendons, the same
symptoms may recur at a later time.
Effect of Corticosteroids
Corticosteroids are strong medications that reduce inflammation. The benefit of guiding
the injection is to provide the strongest effect directly to the inflamed area as opposed to
taking oral steroid medication. Repeat injections can be performed but the timing will be
directed by your doctor. Multiple injections over a short period of time are kept to a
minimum as they can “soften” tendons. You should realize that if a tendon requires an
injection, the tendon is not normal and may be more likely to develop problems at a later
date. Calcifications often clear after the injection, but this can be variable.
Although diabetic patients can safely have steroid injections, it can affect the blood
sugar and care should be taken in monitoring, particularly in insulin dependent
diabetics.
MMIC Approved 6/10
Version 1.1
Risks and Side Effects
Although the risk is low, be aware for signs of infection including redness, warmth, or
swelling at the site of injection, or any fever and/or chills. Bathing and showering is fine.
Keep the injection site clean.
True allergic reactions to steroid injections are relatively unusual and often mild when
they occur. If you feel you are having a form of a reaction, we would be glad to discuss
this with you. In the event that symptoms suggest a more severe reaction, as the case
with any medication, call 911 and seek immediate treatment.
What to do if questions or problems arise
Since doctors who specialize in joint care usually request these injections, the first
course of action regarding activity level, physical therapy, medications or other
questions should be to contact the doctor that recommended the injection. We at Wake
Radiology will be happy to answer any questions related to the injection, so please feel
free to call our office. The Wake Radiology West Raleigh, Lake Boone Trail office
number is (919) 781-6707 and is staffed between the hours of 8am and 5pm Monday
through Friday.
MMIC Approved 6/10
Version 1.1