Therapeutic Joint Injection

Therapeutic joint injections are a minimally invasive treatment option used to relieve pain caused by inflammatory joint conditions such as rheumatoid arthritis, tendonitis, bursitis and gout. Corticosteroids, used to reduce inflammation and minimize pain as a result, are injected into the affected joint. This medication only affects the targeted area and does not usually side effects in most patients. Joint injections are administered under local anesthesia and only cause mild, brief discomfort for patients.

What to Expect:

After local anesthesia, a needle is maneuvered into the area of interest under fluoroscopic guidance. Correct needle placement is confirmed by using a combination of imaging and injection of a small amount of iodinated contrast. A combination of a short-acting anesthetic, such bupivacaine, and an intermediate to long acting corticosteroid, such as triamcinolone, are then injected. The anesthetic can provide immediate pain relief lasting 4-6 hours while the corticosteroid takes effect approximately 1-2 days after the injection, reaching maximum effectiveness within 5-7 days. The duration of the pain relief varies depending on the severity and reversibility of the patient’s condition. If therapeutic effect is achieved, several injections per year can be performed with few long term consequences.

Our musculoskeletal radiologists are well trained in performing diagnostic and therapeutic injections of multiple joints including:

  • shoulder
  • elbow
  • wrist
  • hip
  • sacroiliac
  • knee
  • ankle
  • foot

These procedures are done at our Blue Ridge, Cary and Cedarhurst facilities.

Additional Resources

Image Guided Pain Management – Dr. Jeffrey Browne

Frequently Asked Questions

  • What is the purpose of the exam?

    Joint injections are commonly performed to give pain relief of problematic joints.  Typically a corticosteriod is combined with an analgesic for maximum effectiveness.

  • How is the exam performed?

    A radiologist will cleanse the area of interest, inject a local anesthetic and then insert an injection needle into the affected joint space.  A slight amount of x-ray dye, or contrast, is injected to ensure correct needle placement.  When placement is confirmed, the medications are injected.

  • Are there any restrictions after the procedure?

    No, you can resume normal activities to your degree of tolerance.  Expect to have mild tightness or a full feeling in the joint space from the medications for a few days.

  • How long will the injection last?

    The length of time for relief varies from patient to patient, however many patients have discomfort relieved for up to 6-8 weeks.

Gregory C. Hinn, MD

Musculoskeletal Radiologist
  • Medical Director, Musculoskeletal Imaging at Rex Hospital
  • Medical Director, MRI at Rex Hospital
  • BA, University of North Carolina at Chapel Hill
  • MD, Bowman Gray School of Medicine at Wake Forest University
  • Resident in radiology, University of Virginia Health Sciences Center
  • Fellowship in diagnostic and interventional musculoskeletal radiology, University of Virginia Health Sciences Center
  • Musculoskeletal radiologist for the North Carolina State University Athletic Department.
  • Native of  North Carolina

Expertise in musculoskeletal imaging with bone and joint intervention
Joined Raleigh Radiology in 1995

Tracey E. O’Connell, MD

Musculoskeletal & Abdominal Imaging Radiologist
  • BA, University of Colorado at Boulder
  • MD, University of North Carolina at Chapel Hill
  • Resident in radiology, University of North Carolina at Chapel Hill
  • Fellowship in musculoskeletal radiology, Duke University Medical Center
  • Member, Radiological Society of North America
  • Native of California

Expertise in musculoskeletal imaging with bone and joint intervention and abdominal imaging including MRI, MRA, CT, and ultrasound
Joined Raleigh Radiology in 2001

Gintaras E. Degesys, MD

Musculoskeletal & Abdominal Imaging Radiologist
  • BA, Kenyon College
  • MD, University of Cincinnati College of Medicine
  • Internship and chief resident, Northwestern University
  • Fellowship in interventional and abdominal imaging, Duke University Medical Center
  • Certificate of Added Qualifications in Vascular and Interventional Radiology awarded by  American Board of Radiology
  • Native of Ohio

Expertise in musculoskeletal imaging, breast intervention, and abdominal imaging and intervention
Joined Raleigh Radiology in 2002

Steven R. Carter, MD

Musculoskeletal Radiologist
  • BS, University of Virginia
  • MS, Medical College of Virginia
  • MD, Medical College of Virginia
  • Internship in internal medicine, MCV
  • Chief resident, diagnostic radiology, Emory University
  • Fellowship in musculoskeletal imaging, Emory University
  • Member, American Roentgen Ray Society, American College of Radiology, Radiological Society of North America
  • Musculoskeletal radiologist for the Carolina Hurricanes
  • Native of Richmond, Virginia

Expertise in musculoskeletal radiology
Joined Raleigh Radiology in 2005

Joshua B. Mitchell, MD

Musculoskeletal Radiologist
  • BA, University of Virginia
  • MD, University of Tennessee College of Medicine
  • Internship, Medical University of South Carolina
  • Chief resident, Medical University of South Carolina
  • Fellowship in musculoskeletal radiology, University of Florida
  • Member, Society of Skeletal Radiology
  • Member, American College of Radiology
  • Member, American Roentgen Ray Society
  • Member, Radiological Society of North America
  • Member, Association of University Radiologist
  • Member, North Carolina Medical Society
  • Native of Chattanooga, Tennessee

Expertise in musculoskeletal imaging
Joined Raleigh Radiology in 2007

Jeffrey Browne, MD

Musculoskeletal Radiologist
  • Medical Director of CT for Rex Hospital
  • BS, Boston College
  • MD, University of Connecticut School of Medicine
  • Internship, St. Raphael’s Hospital
  • Residency, Duke University Medical Center
  • Fellowship in musculoskeletal radiology, Duke University Medical Center
  • Member, American College of Radiology, Radiological Society of North America and American Roentgen Ray Society.
  • Native of Connecticut

Expertise in musculoskeletal imaging
Joined Raleigh Radiology in 2008

Jason R. Harris, MD

Vascular and Interventional Radiologist
  • BS, Brigham Young University
  • MD, Harvard Medical School
  • Internship, Newton-Wellesley Hospital, Newton, Massachusetts
  • Residency, Massachusetts General Hospital, Boston, Massachusetts
  • Fellowship in vascular and interventional radiology, Duke University Medical Center
  • Member, American College of Radiology, Society of Interventional Radiology
  • Native of California

Expertise in vascular and interventional and musculoskeletal radiology
Joined Raleigh Radiology in 2008

 

No special preparation is necessary before joint injections. Food and fluid intake do not need to be restricted.

You should inform your physician of any medications you are taking and if you have any allergies, especially to iodinated contrast materials. Also inform your doctor about recent illnesses or other medical conditions.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation.

Blue Ridge 919-781-1437 - Cedarhurst 919-877-5400 - Cary 919-781-1437
Clayton 919-877-5400 - Wake Forest 919-877-5400 - Brier Creek 919-877-5400