Ultrasound and CT Guided Injections

This procedure uses CT or ultrasound to find the correct area where the injection should be given. For example, it can be used to help in finding the joint or soft tissue into which a corticosteroid (steroid type medicine) or local anaesthetic needs to be injected to reduce inflammation and provide pain relief. This procedure is most often used in the shoulder, knee, hip and spine.

A radiologist will perform the examination.

Preparation
Bring diagnostic scans to assist with locating the treatment area.

Bring a driver to take you home after examination, as you will not be allowed to drive home yourself.

On arrival, you are required to complete a consent form, outlining your medical history and allergies. It is important that you tell your own doctor and staff at the radiology facility where you are having the procedure if there is any chance you might be pregnant. This is important information, as it will make a difference in the way the procedure is carried out or a different test altogether might be required. Your safety and that of your unborn child is the number one priority.

Depending on the type of examination you are having you may need some preparation. For some scans you will be asked to change into a gown.

You may also be asked to remove your pins, chains or other items of jewellery before the examination, as these can sometimes interfere with examination.

Although many injections are painless, a local anaesthetic may be given if needed. The whole test should take 10 to 40 minutes, depending on the area being injected.

If local anaesthetic is given, you will feel numbness in the area for up to 2 hours. This will affect your mobility.

Results
Our experienced radiologist will specify what kind of procedure was performed and what medication was used. You will be asked to wait for this report after your procedure. If any pathology was taken, they will be sent to Douglass Hanly Moir Pathology for testing. These pathology results will be sent directly to your doctor in 2-3 working days.

Risks
There are no known risks with the use of ultrasound. There is a small risk of infection due to the open wound. The procedure can be repeated but no more than three or four times a year to avoid damage to the joints. This will be discussed with you if needed.

Ultrasound Guided Biopsies

An ultrasound-guided biopsy (core or fine needle aspiration biopsy) uses sound waves to help locate a nodule or abnormality within the breast/thyroid/neck and remove a tissue sample for examination under a microscope. The procedure is less invasive than surgical biopsy, leaves little to no scarring and does not involve exposure to ionizing radiation.

Nodules or abnormalities in the body are often detected by imaging examinations. However, it is not always possible to tell from these imaging tests whether a nodule is benign (non-cancerous) or cancerous.

This procedure requires little to no special preparation. Tell your doctor about any medications you're taking, such as aspirin or blood thinners.

Ultrasound guided biopsy procedures are performed by a specially trained radiologist with experience in needle aspiration and ultrasound.

Preparation
Bring diagnostic scans to assist with locating the treatment area.

Complete consent form.

Depending on the type of examination you are having you may need some preparation. For some scans you will be asked to change into a gown.

You may also be asked to remove your hairclips, earrings, pins, chains or other items of jewellery before the examination, as these can sometimes interfere with examination.

The area to be biopsied will be checked and an area of skin will be cleaned with an antiseptic. You maybe give local anaesthetic to numb the skin and insert a needle to obtain some tissue. Several samples of tissue maybe required.

The whole procedure should take 10 to 40 minutes, depending on the area being biopsied.

Results
The extracted tissue will be sent to pathology for study and the pathologist examines the removed specimen and makes a final diagnosis so that treatment planning can begin. The results will be sent to your treating doctor to discuss with you. This usually takes 2 to 4 working days.

Risks
The doctor believes the benefits to you from having this procedure exceed the risks involved.

The risks and complications with this procedure can include but are not limited to the following.

Common risks and complications include:
- Pain or discomfort at the puncture site. This may require medication.
- Bleeding or bruising may occur. This is more common if you take Aspirin, Warfarin, Clopidogrel (Plavix and Iscover) or Dipyridamole (Persantin and Asasantin).
- Failure of local anaesthetic which may require a further injection of anaesthetic or a different method of anaesthesia may be used.
- Nerve damage, is usually temporary, and should get better over a period of time. Permanent nerve damage is rare.

Less common risks and complications include:
- Infection, requiring antibiotics and further treatment.
- Damage to surrounding structures such as blood vessels, organs and muscles, requiring further treatment.
- Excessive bleeding from the puncture site. This may require other treatment and/or corrective surgery.
- An allergy to injected drugs, requiring further treatment.
- (Breast biopsies only) Pneumothorax, a collection of air around the lining of the lungs. This usually stops by itself but sometimes may require a tube to be inserted into the chest.
- The biopsy procedure may not obtain enough tissue and may need to be repeated at a later date.
- The procedure may not be possible due to medical and/or technical reasons.

Rare risks and complications include:
- Seizures and/or cardiac arrest due to local anaesthetic toxicity.
- Death as a result of this procedure is very rare.

More Information
- InsideRadiology by the Royal Australian and New Zealand College of Radiologists
- RadiologyInfo by the American College of Radiology and Radiological Society of North America
- The Australian Radiation Protection and Nuclear Safety Agency
- The Alliance for Radiation Safety in Pediatric Imaging
- ACI Radiology Network

Printer-friendly Injection Fact Sheet
Printer-friendly Biopsy Fact Sheet

Image placeholder

Dr Kit Lam

Radiologist

Dr Kit Lam graduated from The University of Sydney and spent his intern and resident years at Westmead Hospital. He worked as a GP and university tutor for 3 years before starting radiology training at the Children’s Hospital at Westmead and the Prince of Wales Hospital. His research at university was on optic nerve development in which he was awarded a B.Sc(med) medal.

Dr Lam specialises in spinal, joint and tendon injections and has performed thousands of procedures for pain relief.