Ultrasound-Guided Injections: Precision Treatment for Your Musculoskeletal Pain
Key Takeaways
- Ultrasound-guided injection uses real-time ultrasound to guide the needle with millimetre precision to the treatment area.
- This technique treats tendonitis, bursitis, osteoarthritis and other musculoskeletal conditions with a higher success rate than standard injections.
- The three main types of injections are cortisone (anti-inflammatory), hyaluronic acid (viscosupplementation) and PRP (tissue regeneration).
- The procedure takes 10 to 15 minutes and risks are minimal thanks to real-time visualization of anatomical structures.
Every year in Quebec, thousands of people seek care for joint, tendon or ligament pain. Among the therapeutic options available, ultrasound-guided injection stands out as a precision solution that is transforming the management of musculoskeletal conditions. Unlike a standard injection performed "blindly" using anatomical landmarks, ultrasound-guided injection allows the physician to visualize the needle, the target and surrounding structures in real time. The result: enhanced accuracy, less pain and better clinical outcomes.
What is an Ultrasound-Guided Injection?
Ultrasound-guided injection is a minimally invasive medical procedure that involves injecting medication directly into a targeted musculoskeletal structure (joint, tendon, bursa) under visual guidance using ultrasound. The ultrasound device acts as a "medical GPS," allowing the physician to precisely locate the pathological area and guide the needle while avoiding blood vessels, nerves and other healthy tissues.
This technique is performed by Dr. Sébastien Bolduc in Saint-Hubert, on Montreal's South Shore. It is part of a modern musculoskeletal medicine approach that favours targeted, effective and minimally invasive treatments.
The Three Main Types of Injections
Depending on the diagnosed condition, the physician may choose from three main categories of injectable products:
Cortisone Injection
Cortisone is a corticosteroid with powerful anti-inflammatory properties. Injected directly into an inflamed area (tendonitis, bursitis, arthritis), it provides rapid relief, often within 24 to 72 hours. Its cost is $75. Learn more about cortisone injections.
Hyaluronic Acid Injection
Hyaluronic acid, also known as viscosupplementation, works by replacing or supplementing the synovial fluid in arthritic joints. It improves lubrication, reduces friction and slows cartilage degradation. Particularly indicated for osteoarthritis of the knee, hip and shoulder. From $525. View available products.
PRP (Platelet-Rich Plasma)
PRP uses the patient's own blood to concentrate platelets and growth factors. Injected into a damaged tendon or joint, it stimulates natural tissue regeneration. This therapy is especially suited for chronic tendinopathies and ligament injuries. From $825. Learn more about PRP.
What Conditions Can Be Treated?
Ultrasound-guided injection is effective for treating a wide range of musculoskeletal conditions:
- Tendonitis: inflammation of a tendon, common in the shoulder (rotator cuff), elbow (epicondylitis), knee and Achilles tendon.
- Bursitis: inflammation of the bursae, often in the knee, elbow or hip.
- Osteoarthritis: joint cartilage wear, treated with hyaluronic acid viscosupplementation.
- Plantar fasciitis: inflammation of the plantar fascia under the foot.
- Morton's neuroma: painful nerve thickening between the metatarsals.
- Carpal tunnel syndrome: compression of the median nerve at the wrist.
- Heel spur: bony growth on the heel associated with local inflammation.
How is the Procedure Performed?
The complete procedure is carried out in five steps and takes between 10 and 15 minutes:
- Assessment and localization: the physician uses ultrasound to locate the pathological area, blood vessels and nerves to avoid.
- Disinfection: the injection site is cleaned with an antiseptic to prevent any risk of infection.
- Local anesthesia (if needed): a local anesthetic can be applied to minimize discomfort.
- Guided injection: the needle is inserted and tracked in real time on the screen to the target, and the medication is then injected.
- Post-procedure monitoring: the patient is observed for a few minutes before leaving. No immobilization is required.
Good to know: ultrasound-guided injection requires no special preparation. You can drive and resume your daily activities immediately after the procedure.
Benefits of Ultrasound Guidance Compared to Standard Injection
Several clinical studies demonstrate the superiority of ultrasound-guided injection over blind injection. Here are the main advantages:
- Millimetre precision: the physician sees the needle reach the target, eliminating guesswork.
- Less pain: sensitive structures (nerves, blood vessels) are identified and avoided before injection.
- Better results: the medication is deposited exactly where it needs to act, maximizing its effectiveness.
- Enhanced safety: the risk of intravascular or intraneural injection is virtually zero.
- No radiation: unlike fluoroscopy (X-rays), ultrasound does not expose the patient to ionizing radiation.
Pricing
Ultrasound-guided injections are offered on a private fee basis. Applicable fees are as follows:
- Consultation visit: $279
- Ultrasound-guided injection (1 site): $159*
- Ultrasound-guided injection (2 sites): $239*
- Cortisone product: $75
- Hyaluronic acid product: from $525
- PRP (Cervos 40 ml): $825
* Visit fees and product cost not included. View all pricing.
Frequently Asked Questions
- Is ultrasound-guided injection painful?
- Most patients experience mild discomfort from the needle stick, comparable to a blood draw. The precision of ultrasound guidance helps avoid sensitive tissues and reduces pain compared to a blind injection. Local anesthesia can be applied if needed.
- How long does an ultrasound-guided injection take?
- The complete procedure takes between 10 and 15 minutes. Patients can resume normal activities immediately afterward.
- What is the difference from a standard injection?
- Standard injection relies on palpable anatomical landmarks, which limits accuracy for deep structures. Ultrasound-guided injection provides real-time visualization of the needle and target, offering millimetre precision and better safety.
- How many sessions are needed?
- The number of sessions varies depending on the condition being treated. Some conditions like acute tendonitis may be relieved with a single injection. Others, such as osteoarthritis treated with hyaluronic acid, may require one to three sessions.
- What are the risks?
- Risks are minimal: temporary pain, local redness or a small bruise. The risk of infection is very low thanks to sterile technique. Ultrasound guidance significantly reduces the risk of injection into a blood vessel or nerve.
- Can I resume sports after an injection?
- Relative rest for 24 to 48 hours is recommended. Your doctor will advise you on when to resume athletic activities, generally after a few days to a week depending on the product injected.
Ready for a consultation?
Dr. Sébastien Bolduc welcomes you in Saint-Hubert for a personalized assessment of your musculoskeletal condition.
8131 boul. Cousineau, Bureau 203, Saint-Hubert, QC J3Z 0G6