Joint Injections and Aspirations

Joints that are commonly injected include the knee, shoulder, ankle, elbow and wrist, as well as small joints of the hands and feet. We also offer sacroiliac injections. Hip joint injection may require the aid of an X-ray called fluoroscopy for guidance. Facet joints of the lumbar spine (low back area) may also be injected by experienced rheumatologists, orthopedists, anesthesiologists and radiologists.

Our muskuloskeletal team, which performs aspirations and injections, is led by Thomas J. Learch, MD, chief of Muskuloskeletal Radiology.

Joint injections are given to treat inflammatory joint conditions, such as rheumatoid arthritis, psoriatic arthritis, gout and osteoarthritis. Most joint injections use anti-inflammatory drugs called corticosteroids (such as methylprednisolone or triamcinolone). Corticosteroids are frequently used for this procedure as they are anti-inflammatory agents that slow down the accumulation of cells responsible for producing inflammation within the joint space.

Although corticosteroids may also be successfully used in osteoarthritis, their mode of action is less clear. Hyaluronic acid (Hyalgan®, Synvisc®) is a viscous lubricating substance that may relieve the pain of osteoarthritis of the knee or other degenerative joint diseases.

Corticosteroids act locally and have few systemic side effects (such as a fever, rash or a disturbance of an internal organ). Common side effects include allergic reactions to the medicines injected into joints, to tape or to the betadine used to clean the skin. Infections are extremely rare. Another uncommon complication is post-injection flare — joint swelling and pain several hours after the corticosteroid injection — which occurs in about one out of 50 patients and usually goes away in several days.

Joint aspiration is usually performed as a diagnostic or therapeutic procedure. Laboratory analysis of the fluid taken from a joint may include:

• White and red blood cell counts
• Crystal analysis to confirm the presence of gout or pseudogout
• Cultures to determine if there is an infection inside the joint

Draining fluid from a large joint effusion can provide pain relief and improved mobility. Injection of a drug into the joint may yield complete or short-term relief of symptoms.  

The S. Mark Taper Foundation Imaging Center provides a full range of advanced imaging, both radiology and cardiology, as well as interventional radiology and interventional tumor (oncology) treatments to the greater Los Angeles area, including Beverly Hills, Encino, Mid-Cities, Sherman Oaks, Silver Lake, Studio City, Toluca Lake and West Hollywood.