Joint interventions

Image-guided joint aspiration or injection

An image-guided joint injection is performed to administer medication (steroid solution) directly into a painful or swollen joint. This permits the infusion of the medication (steroid) directly into the effected joint and minimize the need for systemic (whole body) distribution of the medication. A joint aspiration is performed to remove fluid that has accumulated from a joint before an injection or to diagnose the cause of a swollen or painful joint. The interventional radiologist or physician assistant uses imaging tools (ultrasound and/or fluoroscopy) to guide a small thin needle into the joint space. In turn, medication can be injected or joint fluid remove. Joints that are commonly treated include, knee, hip, shoulder, ankle, elbow, wrist, hand, foot, and joints in the lower back or pelvis.

Conditions treated

Joint swelling or pain can be caused by inflammation within the joint. Inflammation of a joint can have many different causes including arthritis and infection, which are two common reasons to have a joint injection or joint aspiration procedure performed.

Treatment process and recovery

The procedure typically requires 15-30 minutes to complete. It may take longer if multiple joints are affected. Sedation or anesthesia can be used for very young patients or patients who are unable to lie still during the procedure. This can help facilitate the successful completion of the procedure and help to minimize anxiety for your child. However, it is not uncommon to perform the procedure with some local numbing medication and not require any or very little sedation or anti-anxiety medication given orally. Most often you and your child can go home shortly after the procedure is finished. This depends on your child's condition and whether or not sedation is used.

Your child may have some soreness at the puncture site for a few days after the injection. Typically this can be controlled with ibuprofen or Tylenol.

The recovery process will depend on the severity of your child's joint problem. Your child should avoid vigorous physical play or sports for 2 days after an injection. Your child may then resume activities that are normal for them. If an infection is diagnosed, your doctor will discuss activity limitations with you.

Risks of treatment

Whenever the skin barrier is broken there is a chance of developing an infection. The chance of developing an infection is felt to be less than one in 1,000 for this procedure. This is considered very low risk.

Bleeding is possible, but unlikely. Generally, there is little or no bleeding with this procedure. Let your doctor know if your child is taking blood thinners or has a history of a bleeding disorder.

Fat necrosis, or shrinking of the fat under the skin, is a possible risk if steroids are injected into a joint. This can occur if the medication leaks out of the joint and into the fat under the skin. There are techniques that we use to prevent this from happening. Fat necrosis is rarely seen.