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Cortisone injections can provide much-needed relief for ongoing and chronic pain. 

Cortisone can help relieve pain and swelling quickly by helping to reduce inflammation and swelling in a joint or around a tendon. The accuracy of these injections is important in their administration. Ultrasound machines have helped us improve this accuracy by allowing us to guide the injection needle to a more exact location under direct visualization. When a cortisone shot helps with pain relief, a person can often more easily engage in other methods of physical therapy or treatment needed to help the injury fully heal.

Ultrasound-guided images can help us more accurately administer a cortisone injection. Just as a mom-to-be and her doctor are able to more clearly see her unborn baby on an ultrasound picture, we can use an ultrasound image to look at different muscles, tendons, and joints in the body. Those images can help us guide a needle directly to where we need it for an injection. Ultrasound pictures are created using sound waves at a high frequency. 

They also do not use harmful ionizing radiation, meaning they allow us to see what we need to in order to treat you, without putting you in danger of radiation exposure. Here is what else you should know about these types of injections that can help relieve pain and treat a number of conditions:

Why would I need an ultrasound-guided injection?

A cortisone injection administered under ultrasound guidance offers a very specific way to administer the treatment or medication into a specific area. This level of accuracy can be important especially in cases where there are more painful or dangerous areas close by to the injection site. Ultrasound-guided injections can be used to treat a range of issues including arthritis, bursitis, tendonitis, joint and muscle pain, neck and back pain, sciatica, tendinopathy and more.

How are ultrasound-guided injections different from other cortisone injections?

The picture from an ultrasound helps us guide a needle directly to where we need it to administer an injection. Ultrasound allows us to have a visual view of fluids so we can determine if the medicine is being placed exactly where it should be. This also means a high likelihood your procedure will have a more effective outcome.

What happens during this type of injection?

Ultrasound-guided injections are performed much in the same way as traditional injections. To ensure the images come in clear, ultrasound gel is put directly on your skin in the affected area and allows us to view the areas we need to through an ultrasound probe. We use a monitor to pinpoint the site of the injection and it is given with the same type of needle used in a regular cortisone injection. These injections are done in our clinical offices during a normal patient visit and you do not need to be under anesthesia.

What are the benefits?

The ultrasound machine certainly helps us guide needle placement for injection accuracy without the use of X-ray. An ultrasound-guided injection, however, does not take the place of MRI or CT scan. If someone is unable to have an MRI due to a pacemaker or does not want a CT scan due to exposure to radiation, diagnostic ultrasound may be performed to evaluate for certain pathologies such as a rotator cuff tear. A diagnostic ultrasound does not involve an injection. It is simply the use of the ultrasound machine to visualize the soft tissue and tendon attachments. The ultrasound does not tend to be as accurate as MRI or CT scan, but it can give us a better understanding of pathology with less risk for certain patients.

Matt Dobler, PA-C, ATC is a physician assistant at the OrthoCarolina Sports Medicine Center.

This article was originally published on February 25th, 2018, and updated on August 25th, 2021.


January 16, 2023

Great read!!! Thanks for sharing such a great blog, blog like these are beneficial.
- Mark Hamlin

August 23, 2018

Thanks dr. for your clarity.
- marjorie meyer
Reply From: OrthoCarolina

August 23, 2018

You are welcome Marjorie

May 10, 2018

Matt Doppler is my new best friend! He does a great job on my knee injections without ultrasound! Hard to believe he could be any better with US! I do have a couple questions not sure if we get answers here, but it's worth a try. Can you do intra-articular injections with ultrasound? Can a steroid injection be done on top of or with a Euflexxa injection?
- Dana MacPherson
Reply From: OrthoCarolina

May 10, 2018

Hi Dana, Thank you for the kind words! Please contact Matt directly at 704.323.3000 so he can address your questions.