Joint injections are usually undertaken when your doctor believes that your pain could potentially be relieved by a direct injection of cortisone (anti-inflammatory medication)  to the injured area. The injection procedure is carried out by a radiologist with special training, and assisted by a radiographer or sonographer. A fine needle is used to introduce local anaesthetic (to numb the area) and cortisone into the joint using guidance with CT or ultrasound imaging to allow for the best accuracy.

Spinal injections can be targeted to specific areas in the spine, depending on your symptoms and your previous scans of the spine. As with a joint injection, the area of interest will be targeted by a radiologist with a local anaesthetic and a type of cortisone specifically designed for use in the spinal area. All spinal injections are carried out using CT guidance to allow for the best possible visualization of your spine.

We will need to know if you are on blood thinners such as Warfarin/Aspirin.

You will need to book an appointment for your injection as you may need to undergo a preparation before the procedure. In most cases, it is preferable for you to have previous images of the area where you will be having your injection to allow our radiologists to accurately target your problem.

If you are taking a blood thinning medication, you may need to stop or reduce your dose for between 3–5 days before a spinal injection. Please do not stop your blood thinners without discussing the safety with your doctor before booking your appointment.

For all spinal injections, we recommend that you bring a driver with you as a safety precaution. Although the risk is low, there is a slight chance that the local anaesthetic can cause you to temporarily experience weakness or numbness in your limbs. Whilst these sensations will subside as the local anaesthetic wears off, it is inadvisable to attempt driving during this period.

Scans are taken to locate its exact position. The skin in the area is sterilised with antiseptic, local anaesthetic given, then a needle is guided into the region of interest followed by injection of local anaesthetic +/- steriod.

A radiographer or sonographer may ask you to undress and wear a gown to allow clear access to the area being injected. They will explain the procedure to you, and ask you relevant safety questions before the radiologist enters the room. The radiologist will prepare the area to be injected with an antiseptic cleaning solution, and use all sterile drapes and instruments during the procedure. It is essential that you keep still at all times to ensure the radiologist can carry out the injection in a safe manner.

A small needle will be given initially with local anaesthetic to numb the area and make the procedure more comfortable. The radiologist will use imaging (CT or ultrasound) to guide the needle to the appropriate area to ensure accurate placement of the cortisone. You may feel some discomfort when the radiologist injects the medication at the end, but this will only be for a brief period of time.

During a spinal injection, you will be lying on your stomach on the CT table. If you do not think you can do this, please tell the reception staff when making your booking, as this can make the procedure difficult.

About 15–30 minutes.

In general, these are very safe techniques and have a very low complication rate.

Once the needle is removed, the area will be cleaned and a band aid will be placed over the needle site. The radiologist will give you post injection instructions, and make sure you are feeling well before you leave the practice.  You will be instructed to rest the area for at least two days to allow the cortisone medication to potentially take effect.

As with any procedure where a needle is placed into the skin, there is a very small chance of bleeding or infection. You will be checked for bleeding before you leave the practice, and given post injection instruction for any potential signs of infection.

With a spinal injection (specifically epidural or nerve root injections), there is a risk of leg weakness or numbness from the local anaesthetic. This is a temporary effect, and you will be monitored in our practice for safety until you show signs of improvement.

There is a very small risk during an epidural injection that the needle could puncture the fluid sac around the spinal canal.

If iodine contrast is used to check the needle position, there is a small risk of allergic reaction (similar to a CT scan with contrast). Most radiologists use air rather than contrast, but please tell the radiographer and radiologist before the procedure if you are allergic to iodine contrast.

It is important that you make an appointment to return to your doctor after you have collected your examination result.

Whether they are normal or abnormal, your doctor needs to correlate with other information for further management.

Depending on your referrer’s preference(s), a copy of the report can also be sent to your referring doctor by fax or electronic download. Digital copies of all studies are stored on our secured database for comparison with any future examinations.

Biopsy is a medical procedure where a sample of tissue is taken from a patient for examination and diagnosis of an illness or medical condition. Biopsies are important in the diagnosis of lesions.

If you are on blood thinners such as Warfarin/Aspirin.

Please bring any previous films with you for comparison.

You will change into a gown and be comfortably positioned so that the area being examined is most accessible. Scans are taken to locate the exact position of the lesion. The skin in the area is sterilised with antiseptic, local anaesthetic given, then a needle is guided into the abnormality and a sample taken. This is repeated 2–4 times until sufficient material is obtained for pathology. More than one sample is needed to avoid sampling error and ensure there is adequate tissue for the pathologist.

About 15–30 minutes.

In general, these are very safe techniques and have a very low complication rate.

There can be some discomfort at the biopsy site but it is usually minor and resolves in 3–4 hours. Ice packs for 10 minutes each hour and simple analgesics such as paracetamol can be used if needed.

It is essential you see your doctor within a few days to get the biopsy result. The pathologist will send their report directly to your doctor within 2–3 days of the biopsy.

Whether they are normal or abnormal, your doctor needs to correlate with other information for further management.

Depending on your referrer’s preference(s), a copy of the report can also be sent to your referring doctor by fax or electronic download.

Digital copies of all studies are stored on our secured database for comparison with any future examinations.

Possible complications of the procedure include bleeding or infection. However, since the procedure is performed under ultrasound guidance and strict aseptic technique, the possibility of such complications is low.