They act to reduce inflammation and pain in an area of need.
Diagnostic (+/- therapeutic)
Sometimes it can be difficult to determine where pain originates from.
In these instances, they can be used to confirm or exclude a suspected joint/region being the cause of the pain or contributing to the pain.
If you have not had a prior ultrasound an expert musculo-skeletal Sonographer or Dr Berman (specialist musculo-skeletal radiologist) will usually first scan the area of concern.
The skin is cleaned with an antiseptic agent. Under ultrasound control the area of concern will be injected with a combination of steroid and local anaesthetic (usually Celestone Chronodose and Marcaine respectively) mixed together in a single syringe.
Occasionally an initial injection of local anaesthetic into the skin will be performed first.
The degree of discomfort varies depending on:
Overall the procedure is well tolerated and usually produces only minimal discomfort.
There can be a slight increase in pain in the area injected for a day or two afterwards. If this occurs it begins when the local anaesthetic has worn off but the steroids have not as yet had time to work.
This is usually mild and helped with the use of analgesia (such as Ibuprofen and Paracetamol) and cold packs.
Usually it takes 2-3 days for the steroids to start taking effect. This again usually gradually improves over 1-2 weeks, with the maximum effect usually at the 2-3 week mark.
After the procedure what you will be able to do will depend on the area injected and reason for the treatment.
Usually light duties and limited exercise will be recommended for about two weeks.
This will be discussed at the time of treatment or you may be referred back to your referring medical practitioner for appropriate aftercare.
If you have any questions or concerns after treatment please contact Dr Berman or your referring doctor.
The response to treatment is variable.
The degree of response to treatment depends on several factors; including:
Overall steroids are very effective agents and about 70% of patients get improvement. This improvement can be quite dramatic in many cases.
What is injected?
The typically used agent is CELESTONE CHRONODOSE or DEXAMETHASONE. (Occasionally other agents such as Kenocort are used. Different doctor’s preference).
These are not “anabolic” agents. The use in sport is permitted as long as they are not injected systemically (i.e. not intramuscular, intravenous, rectally or orally)
The procedure is usually well tolerated and adverse reactions are rare.
To download a Patient Information Brochure please click on the link below.:
Independent Sports Imaging – Patient Fact Sheet on Steroids/Cortisone