Musculoskeletal Ultrasound Guided Injection Information & Consent Form

Steroid injections are a process of delivering powerful anti-inflammatory medication into a joint or soft tissue. An injection is generally safer than taking anti-inflammation medication by mouth. Steroids can help reduce inflammation and pain. They are generally used to assist and promote a rehabilitation process. Please note, these are not muscle building steroids. Local anaesthetic may also be used during the procedure (like the dentist). This medication wears off after 20-30 minutes. The steroid begins to work approximately 48 hours after injection and is expected to have a therapeutic effect for up to 6-12 weeks.

Risks:

The possible side effects of the injection are rare and include:

Unfortunately no treatment will be effective for every patient and whilst most patients will experience at least partial benefit, a minority of patients may experience no significant relief.

Flushing of the face for a few hours.

Small area of fat loss or change in skin colour around the injection site.

A temporary increase in pain after the injection. With a steroid injection this may last 24-48 hours. If you experience increased pain for a longer period then please contact us for advice.

Hyarulonic Acid injections may very rarely gives rise to a more prolonged post injection flare lasting for several weeks.

Patients with increased blood pressure (hypertension) may notice a temporary increase in blood pressure. If your blood pressure is unusually high, unstable or you have recently changed blood pressure medication please notify your clinician prior to any injection.

Patients with Ocular Hypertension/ Glaucoma should ensure their condition is stable or check with their ocular clinician to ensure a steroid injection is safe. Steroids are known to raise intraocular pressure for a short period of time.

Patients with diabetes may notice a temporary increase in blood sugar levels. If you have diabetes, you are advised to check your blood sugar levels for 7 days post-injection.

Temporary bruising or bleeding in the injected area, especially if you are taking antiplatelet medicines (such as aspirin) or anticoagulant medicines (such as warfarin). Please advise the team if you are taking any blood thinning medicines.

Infection: If the area becomes hot, swollen, and painful for more than 24 hours, or if you feel generally unwell, you should contact your clinician immediately. If they are unavailable, you should seek advice from your GP or Emergency Department (A&E).

For injections in and around tendons there is a small risk of tendon damage or rupture.

Slight vaginal bleeding/menstrual irregularities.

Allergic reaction or severe allergic reaction (anaphylaxis) to the drug: This will usually happen immediately so you will be asked to wait for a short time after your injection to check for any reactions.

Very rarely loss of consciousness, respiratory depression, respiratory or cardiac arrest.

For ladies who are breastfeeding; Studies have shown the amount of steroid and local anaesthetic that passes to breastmilk is safe at the doses we use.

Advice after an ultrasound guided injection:

Local anaesthetic used during the procedure (like the dentist) wears off after a few hours and some mild pain may occur. If tolerated, analgesia can be used to moderate this discomfort.

Steroid begins to work approximately 48 hours after injection and is expected to have a therapeutic effect for up to 12 weeks.

There is generally no need to cease daily activities but if you have post-injection pain, analgesia medication and sensible activity modification should be considered.

Clinical follow up after an ultrasound guided injection:

We will arrange a follow-up message & telephone review appointment with you 2-4 weeks after your injection to assess your progress.

Patient Consent:

> I have read and understood the details, risks and benefits of the procedure to be carried out.

> I have been given the opportunity to ask any questions about my condition, other treatment options (including no treatment) and about the planned procedure.