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Real-time image guidance

Ultrasound-guided injections, targeted with

precision.

Consultant-led procedures for selected joint, tendon, bursal and nerve-related pain, including peripheral nerve blocks, headache interventions and targeted treatment for some forms of persistent pain after surgery.

 

Diagnosis first. Treatment second.

See
Soft tissues in real time

Plan
A safe needle route

 

Guide
Medication to the target

 

Consultant-led assessment

Real-time needle guidance

Musculoskeletal and nerve targets

No ionising radiation

Why use ultrasound?

Precision begins before the needle is inserted.

Ultrasound uses high-frequency sound waves to create moving images of muscles, tendons, ligaments, bursae, joints, nerves and other soft tissues. It does not use X-rays.

The consultant can examine the area, plan a suitable route and watch the needle advance towards the intended target. This is particularly valuable when important tendons, nerves or blood vessels are nearby.

What image guidance adds

The target is identified

The procedure is based on visible anatomy rather than surface landmarks alone.

The needle is watched in real time

Its course can be adjusted while avoiding nearby structures where possible.

Treatment is placed purposefully

Medication or fluid is delivered to the selected joint, bursa, tendon sheath, tissue plane or nerve region.

Ultrasound improves anatomical accuracy. It does not replace correct diagnosis, careful patient selection or a wider recovery plan.
Procedures we provide

More than one type of injection.

Ultrasound can also guide treatment around peripheral nerves and within tissue planes. These procedures are considered only when the pain pattern, examination and relevant investigations support a specific target.

Joint injections

Targeted treatment within selected joints, including the shoulder, hip and knee, when the clinical findings and imaging support this approach.

Bursal injections

Medication is guided into an inflamed or painful bursa, such as the subacromial, trochanteric, ischial or other accessible bursae.

Tendon sheath and peritendinous injections

Selected treatment around a tendon or within a tendon sheath. Medication is not deliberately injected into the tendon substance.

Shoulder hydrodilatation

Fluid is introduced into the shoulder joint to distend the tight capsule in selected patients with frozen shoulder, usually alongside rehabilitation.

Calcific tendinopathy lavage

Also called barbotage, this procedure uses ultrasound guidance to needle and wash selected calcium deposits within a shoulder tendon.

Aspiration and fluid procedures

Fluid may be sampled or drained from selected joints, bursae or cystic lesions when appropriate, sometimes followed by targeted treatment.

Specialist pain procedures

Beyond joints, tendons and bursae.

Ultrasound can also guide treatment around peripheral nerves and within tissue planes. These procedures are considered only when the pain pattern, examination and relevant investigations support a specific target.

Headache and occipital nerve blocks

Occipital nerve blocks may be considered for selected neuralgia, cervicogenic headache or other headache presentations after clinical assessment.

Selected headache and scalp pain

Joint injections

Local anaesthetic, sometimes with corticosteroid, can be placed around a selected peripheral nerve to reduce pain or assess whether that nerve contributes to symptoms.

Diagnostic or therapeutic nerve treatment

Bursal injections

For selected nerve entrapment, fluid may be introduced around a nerve to separate it from surrounding tissue and improve the tissue plane. Suitability depends on the site.

Selected nerve entrapment and neuropathic pain

Tendon sheath and peritendinous injections

Targeted injection may be considered for pain from an injured or trapped nerve, scar, neuroma or abdominal wall structure.

Selected nerve entrapment and neuropathic pain

Shoulder hydrodilatation

Selected ilioinguinal, iliohypogastric, lateral femoral cutaneous, transversus abdominis plane or rectus sheath procedures may help manage focal abdominal, groin or pelvic wall pain.

Including selected pain after surgery

Calcific tendinopathy lavage

Selected intercostal or superficial chest wall nerve blocks may be considered for well-localised neuropathic pain, including persistent pain after thoracic or chest wall surgery.

Careful assessment and imaging review

Aspiration and fluid procedures

A targeted block around the suprascapular nerve may be considered for selected persistent shoulder pain, particularly when pain limits movement or participation in rehabilitation.

Selected chronic shoulder pain

Aspiration and fluid procedures

Depending on the pain pattern, ultrasound may guide selected blocks around superficial sensory nerves or articular nerve branches as part of a broader pain management plan.

Individual assessment required

Areas we assess and treat

Musculoskeletal, nerve and post-surgical pain targets.

Select a region to see examples. The final treatment choice depends on clinical assessment and relevant imaging.

Region 01

Shoulder

Ultrasound can assess the rotator cuff, bursae, biceps tendon and accessible joints, then guide treatment to the selected target.

  • Subacromial bursal injection
  • Glenohumeral joint injection
  • Acromioclavicular joint injection
  • Biceps tendon sheath injection
  • Hydrodilatation for frozen shoulder
  • Calcific tendinopathy lavage
What happens on the day

A straightforward procedure, carefully planned.

Your exact experience will depend on the target and treatment. Most ultrasound-guided injections are performed using local anaesthetic without sedation.

1

Review

Symptoms, medicines, allergies and consent are checked.

2

Scan

The anatomy and intended target are reviewed.

3

Position

You are placed comfortably for safe access.

4

Prepare

The skin is cleaned and local anaesthetic used if needed.

5

Guide

The needle is watched as it reaches the target.

6

Recover

You receive procedure-specific aftercare advice.

Preparing safely

What we need to know before treatment.

Please read your appointment information and tell the clinic if your health, medication or planned surgery has changed.

Do not stop prescribed medication yourself.
 
Blood thinners and antiplatelet medicines require an individual assessment. We will tell you if any change is needed.

Medicines and allergies

Bring an up-to-date list, including anticoagulants, antiplatelets and previous reactions to medicines, dressings or antiseptics.

Diabetes

Corticosteroid can temporarily increase blood glucose. Tell us how your diabetes is managed.

Infection or current illness

Contact the clinic if you have a fever, skin infection near the injection site, are taking antibiotics or feel unwell.

Pregnancy or breastfeeding

Tell us if you are pregnant, may be pregnant or are breastfeeding so medication choices can be reviewed.

Planned surgery

If you are awaiting an operation in the same region, tell both the clinic and your surgical team before having a corticosteroid injection.

Balanced information

Potential benefits, with realistic expectations.

An injection is one part of treatment. Its value is judged by what it helps you do, not simply by whether the procedure can be performed.

What a procedure may help with

Important limitations

No injection can guarantee complete or permanent pain relief. Expected benefit, alternatives and the role of rehabilitation will be discussed before treatment.

Risks and consent

Accurate guidance does not make an injection risk-free.

Most patients have no serious complication. The exact risks vary with the target, medicine and your health, and will be discussed before you consent.

Temporary soreness or a flare of pain can occur after treatment. Serious complications are uncommon, but prompt assessment matters if warning signs develop.

Local discomfort

Pain, bruising, bleeding or a temporary post-injection flare.

Infection

Increasing heat, redness, swelling, fever or feeling unwell needs urgent review.

Skin and soft tissue

Skin thinning, colour change or local fat loss can occur after corticosteroid.

Tendon risk

Tendon weakening or rupture is uncommon but possible, particularly in vulnerable tendons.

Nerve effects

Temporary numbness or weakness can occur. Nerve irritation or injury is uncommon but possible.

General steroid effects

Flushing, sleep or mood disturbance and a temporary rise in blood glucose.

Procedure-specific risks

Some targets have additional risks. For example, chest wall or intercostal procedures carry a small risk of pneumothorax.

No benefit

The procedure may not reduce pain or improve function, even when accurately performed.

Seek urgent medical advice if you develop
 

severe or rapidly increasing pain, fever, spreading redness, marked swelling, persistent new weakness or numbness, breathing difficulty, or signs of a serious allergic reaction.

After your procedure

Protect the opportunity created by treatment.

You will receive advice matched to the procedure and the structure treated. Mild soreness can occur after the local anaesthetic wears off, and corticosteroid benefit may take time to become clear.

If local anaesthetic causes weakness or numbness that could affect control of a vehicle, you must not drive until it has fully resolved. Follow the specific instructions given by the clinic.

 

Follow the written advice

Activity recommendations differ between joints, tendons and other targets.

Expect possible short-term soreness

Use the pain relief and local measures recommended to you.

Restart rehabilitation as advised

The injection often works best as part of a planned recovery programme.

Know the warning signs

Use the contact and emergency advice supplied after treatment.

Consultant-led treatment

Specialist imaging and intervention in one appointment.

The same consultant brings together the clinical problem, ultrasound findings and procedural plan.

Dr Laith Al-Obaidi

Consultant Radiologist and Interventional Pain Specialist

Dr Al-obaidi combines specialist expertise in spinal and musculoskeletal imaging with image-guided intervention. This allows scan findings, clinical assessment and precise procedural planning to be considered as one connected pathway.

Frequently asked questions

Questions, answered clearly.

These answers are general. Your consultation and appointment information will provide advice specific to your procedure.

a clear next step

Could a targeted injection help you move forward?

Start with a specialist assessment. We will review your symptoms and relevant imaging, identify whether there is a sensible target, and explain the benefits, limitations and alternatives before treatment.