Musculoskeletal (MSK) Injections
Musculoskeletal injections are commonly used to treat arthritis, inflammation, or other sources of joint pain in areas including the knee, hip, shoulder, wrist, sacroiliac joints, and finger joints.
Overview
Image-guided musculoskeletal (MSK) procedures are minimally invasive treatments performed by some general Radiologists, as well as specialist Interventional Radiologists (IRs) to help manage joint and soft tissue pain. Using imaging guidance such as ultrasound or X-ray, these procedures allow precise delivery of medication into joints, bursae, or soft tissue structures. They are commonly used to treat arthritis, inflammation, or other sources of joint pain in areas including the knee, hip, shoulder, wrist, sacroiliac joints, and fingers (digital joints). They can also be used for targeted injections into ganglia or other soft tissue structures for treatment of neuropathic pain.
The Procedures
These procedures are usually performed under local anaesthetic, typically without pharmacologic sedation. Imaging ensures the medication is precisely delivered to the area causing pain. Common treatments include:
• Joint Injections: Medication (often corticosteroid and/or local anaesthetic) is injected into the joint space to reduce inflammation and relieve pain. Common joints include the knee, hip, wrist, and sacroiliac joints.
• Bursal Injections: Injections into bursae surrounding joints to relieve inflammation.
• Ganglion Injections: Targeted injections into ganglion cysts to reduce pain and inflammation.
• Small joint & tendon sheath: Injections into small joints, or tendon sheaths for symptomatic relief from inflammatory pathology (i.e. DeQuervain tenosynovitis).
• Neuropathic pain: perineural injections treating benign neuropathic pain, including pathologies such as Carpal Tunnel Syndrome, Occipital Neuralgia (i.e. greater occipital nerve block), Pudendal Neuralgia, Coccydynia, Knee OA pain (Genicular neurolysis), Piriformis syndrome, and Trigeminal Neuralgia.
Procedures typically take 15-30 minutes, depending on the location treated, and patients are observed briefly afterwards before going home the same day. Many of these injections can be performed at our consulting rooms using ultrasound (US) guidance; and more complex procedures will be booked with CT facilities.
Benefits
• Minimally invasive with short recovery time
• Precise targeting of the joint or soft tissue pain generator
• Can reduce pain and improve mobility for patients with arthritis, inflammatory, and neuropathic conditions
• Often reduces the need for oral medications, including anti-inflammatories or opioid
Risks
These procedures are generally safe. Minor complications may include temporary soreness, bruising, or mild swelling at the injection site. Rare complications include infection, bleeding, allergic reaction, or temporary worsening of pain. Your Interventional Radiologist will discuss these risks with you before the procedure.
Aftercare
Patients can resume most normal daily activities the next day, with mild soreness expected for a few hours to a day. We typically advise avoidance of strenuous activity for 1-2 weeks depending on the injection site. Ice packs and simple pain relief can be used to manage minor discomfort. Follow-up will be arranged with your referring practitioner to assess response and plan repeat injections if needs be.
Specialist Care
At Specialist IR, image-guided MSK procedures are performed by experienced Interventional Radiologists in both public and private hospitals across Melbourne, Victoria. Eligible public patients may be able to have these procedures with no out-of-pocket costs. Referrals should include clinical history and any relevant imaging (such as X-ray or MRI) to assist our team in planning the most appropriate treatment.
Preparation and Referral
If you would like to refer to an Interventional Radiologist for consideration of percutaneous treatment, please send a referral for consultation, including the following;
• Recent imaging, which may include US and MRI where relevant
• Records of consultation with other doctors & specialists
MSK Injection procedures are performed at most of our public and private hospital locations in Melbourne, Victoria, Australia.
MSK Injections content by Dr James Lisik.