What are image-guided injections?
Image-guided injections use real-time imaging, either fluoroscopy (live X-ray) or CT, to place medication precisely at the source of pain. Because the needle is guided to the exact target under imaging, the injection is accurate and the surrounding structures are avoided. This precision is the advantage of having these procedures performed by a radiologist.
Injections serve two purposes. They can relieve pain, often by delivering a long-acting anti-inflammatory (corticosteroid) with local anaesthetic to an inflamed structure. They can also help diagnose the source of pain: if numbing a specific joint or nerve relieves the pain, that structure is confirmed as the source, which can guide further treatment.
Common procedures
- Epidural steroid injection for nerve pain radiating into the arm or leg, often from a disc protrusion or spinal narrowing
- Nerve root (transforaminal) injection targeting a specific irritated spinal nerve
- Facet joint injection and medial branch block for pain arising from the small joints of the spine
- Joint injections for the hip, shoulder, knee and other joints
- Tendon and bursa injections for soft-tissue causes of pain
Conditions these can help
Image-guided injections are used for a range of musculoskeletal and spinal conditions, including sciatica and other nerve-related pain, degenerative and arthritic joint pain, facet joint pain, and inflammation of tendons and bursae. They are typically considered as part of a broader plan alongside physiotherapy, exercise and medication, and can be a useful step between conservative measures and surgery.
What to expect
- The skin is cleaned and local anaesthetic is used to numb the area.
- Using imaging guidance, the needle is positioned precisely at the target, and a small amount of contrast may be used to confirm placement.
- The medication is injected. The procedure is usually brief, and most people go home the same day.
Any relief from local anaesthetic may be felt within hours, while the effect of a corticosteroid typically develops over several days. The degree and duration of benefit vary between people and conditions. Your referring doctor will discuss what to expect for your particular situation.
These procedures are performed on referral from your GP or specialist. Please bring any relevant imaging (such as recent X-rays, CT or MRI) to your appointment.