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Intra-articular (into the joint) Injections

Shoulder Joint

The shoulder joint is commonly the cause of shoulder, lateral neck, and upper arm pain. The shoulder joint is located at the junction of the clavicle, scapula, and humerus. This large joint becomes irritated from common wear and tear from repetitive movements, trauma, and/or sporting injuries. Pain usually gets worse over the years as one protects the shoulder by avoiding movement of the shoulder due to pain, and the shoulder becomes frozen.

During the procedure, the patient lies face up on the procedure table in a clean operating room. The patient’s vitals signs are collected and checked for appropriateness. The patient’s shoulder area is cleaned with an antiseptic and draped using sterile technique. Using fluoroscopic (low dose x-ray) guidance, the glenohumeral joint is identified and the skin over the joint is anesthetized. Using a small needle to enter the joint with fluoroscopic guidance, local anesthetic (numbing medications) and steroid is injected. The patient may feel pressure as the medicine is injected. In certain situations, the acromioclavicular joint and subdeltoid bursa is also injected. The patient may have discomfort where the needle was inserted over the next few days, but this will resolve. The steroid takes approximately 48-72 hours to have full effect, where as the local anesthetic wears off in approximately 8-12 hours. Please allow three days to assess the efficacy of the procedure.

Hip Joint

The hip joint is commonly the cause of groin, lateral thigh, and radiating knee pain. The hip joint is located at the junction of the thigh into the waist, or in more technical terms, where the femur inserts into the pelvic bone. This large joint becomes irritated from common wear and tear from repetitive movements, trauma, and/or sporting injuries. Pain usually gets progressively worse over the years as this joint is continuously involved in walking and bears all of the body’s weight. This joint is usually mistaken to be the cause of waistline hip or lateral buttock pain (which is most of the time caused by the sacroiliac joint), but true hip pain is usually located in the front groin area.

During the procedure, the patient lies face up on the procedure table in a clean operating room. The patient’s vitals signs are collected and checked for appropriateness. The patient’s hip area is cleaned with an antiseptic and draped using sterile technique. Using fluoroscopic (low dose x-ray) guidance, the acetabulofemoral joint, the joint between the femur and acetabulum of the pelvis joint is identified and the skin over the joint is anesthetized. Using a small needle to enter the joint with fluoroscopic guidance, local anesthetic (numbing medications) and steroid is injected. The patient may feel pressure as the medicine is injected. The patient may have discomfort where the needle was inserted over the next few days, but this will resolve. The steroid takes approximately 48-72 hours to have full effect, where as the local anesthetic wears off in approximately 8-12 hours. Please allow three days to assess the efficacy of the procedure.

Knee Joint

The knee joint is very well known in location and the pain pattern it creates. This large joint becomes irritated from common wear and tear, trauma, and/or sporting injuries. The knee supports nearly the whole weight of the body, it is the joint most vulnerable to both acute injury and the development of osteoarthritis. Pain usually gets progressively worse over the years due to constant use during walking.

During the procedure, the patient is either able to sit in a chair or lie face up on the procedure table. The patient’s knee is cleaned with an antiseptic and draped using sterile technique. Using a lateral or medial approach, the knee joint, the skin over the joint is anesthetized. Using a small needle the joint is entered, any fluid in the joint is aspirated. And finally local anesthetic (numbing medications) and steroid is injected. The patient may feel pressure as the medicine is injected. The patient may have discomfort where the needle was inserted over the next few days, but this will resolve. The steroid takes approximately 48-72 hours to have full effect, where as the local anesthetic wears off in approximately 8-12 hours. Please allow three days to assess the efficacy of the procedure.