Ultrasound Guided Steroid Injections in the Radiology Department
What will happen on the day?
The injection will be given in the Radiology department at Royal Lancaster Infirmary or Furness General Hospital.
An ultrasound scan will be performed to check for any abnormality and a skin marking will be made at proposed site of injection.
Your skin will be cleaned with antiseptic and local anaesthetic (injection and/or spray) applied to numb the area being injected. This numbness usually lasts one hour but can last up to 24 hours in some people.
Once the area is numb, a needle will be inserted under ultrasound guidance.
Ultrasound helps to ensure the steroid can be given in the precise area of pain/inflammation. This will maximise the chance of effective pain relief.
The steroid is then injected and the needle removed. There may be a feeling of fullness within the area while the steroid is being absorbed. A small plaster/bandage may be placed over the injection site.
The numbness from local anaesthetic can make it difficult to drive and you are recommended to avoid driving for 24 hours after the injection.
You should expect the procedure to take around 30 minutes. You should take care not to overuse the injected area for 24-48 hours following your procedure. Please take care of the numb area so as not to injure it.
What is a steroid injection?
Steroids, also called corticosteroids, are anti-inflammatory medicines used to treat a range of conditions. They're different from anabolic steroids, which are often used illegally by some people to increase muscle mass.
Steroids come in many forms, including tablets and inhalers. However, we will only refer to the injectable form in this information.
By reducing the inflammation within an area, steroids can alleviate pain and swelling.
Injectable steroids are useful in multiple conditions, including osteoarthritis, rheumatoid arthritis, bursitis, tendinitis, Morton's neuroma, plantar fasciitis and carpal tunnel syndrome to name a few.
By injecting the steroid, it is able to directly work upon the required area.
Pain may improve immediately but can take up to a week. Results may last between days, to up to six months.
Most people will not experience side effects. However, below are some risks for you to be aware of:
- Pain at injection site: this is very common and simple pain relief should help.
- Bleeding/Bruising: a small amount of bleeding is common and should settle within a few minutes. There may be some bruising which can last one to two weeks.
- Steroid Flare: some people experience significant increase in pain caused by the steroid. It usually settles within 24-48 hours. Simple pain relief can help.
- Infection at injection site (less than 1% chance): this is very rare. If the area injected or associated joint becomes red, painful, hot or swollen, see your doctor immediately.
- Colour change/skin dimpling (fat necrosis) at injection site: this is uncommon but can be permanent.
- Tendon injury: this is rare and usually seen with multiple steroid injections in the same area. Be guided by your clinician about appropriate activity levels post injection.
- High blood sugar: in diabetic patients blood sugar levels may rise two to three days after the injection. If you are diabetic and not comfortable managing your sugar levels or are concerned, please speak to your doctor or nurse.
- Facial flushing and change to menstrual cycle: some of the steroid is absorbed into the bloodstream and can cause these temporary effects.
- Allergic reaction: this is rare. Please let the radiologist doing the injection know if you have any allergies.
Can everyone have a steroid injection?
No. There are a few situations in which a person may be unsuitable:
- Infection around the injection site/multiple steroid injections in the same area. We usually avoid giving steroid injections within three months of each other and usually do not exceed more than three per year to avoid side effects.
- Conditions that affect blood clotting/increase your risk of bleeding. Please let the radiologist know if you are on blood thinners. The majority of steroid injections are low risk in terms of bleeding and therefore no modification of your blood thinners is needed pre-procedure. In a small number of cases we may need to consult haematology to gain their advice.
- Recent vaccination or immunosuppression. Steroids dampen your immune system and may reduce the effectiveness of vaccines. Therefore we usually suggest a two week gap between vaccine and steroid injections. Please get in touch if you have a vaccine planned so that we can consider rescheduling your appointment.
- You will be asked about your medical history. It is important you tell us if you are taking any medication for HIV (protease inhibitors / antiretrovirals e.g. Ritonavir), are on replacement steroids or are sensitive to steroids. A small number of patients (around 10%) with HIV on protease inhibitors can develop suppression of their adrenal glands after steroid injection.
- There is no interaction of steroids with oral contraceptives.
Radiology Department Secretaries:
Telephone:
01524 516284 or 01524 516297