Ultrasound-guided foot and ankle injections can be a useful part of treatment for selected causes of foot and ankle pain. They may be considered after specialist assessment, often alongside other non-surgical measures, and can sometimes help both with symptom relief and with clarifying the source of pain.
Mr Edward Dawe is a Consultant Trauma and Orthopaedic Surgeon specialising exclusively in foot and ankle surgery. Foot and ankle injections are usually performed under ultrasound guidance or X-ray guidance, depending on the condition being treated and the structure being targeted.
Image-guided injection can be particularly useful when the aim is to place treatment accurately into a joint, around a tendon, into a bursa, or adjacent to another specific structure in the foot or ankle. In many cases, injections are considered before surgery, although the likely benefit depends on the condition being treated.
Guidance helps improve the accuracy of foot and ankle injections. Ultrasound guidance allows the soft tissues to be visualised in real time, while X-ray guidance may be used when a joint or bony target is better assessed in that way.
The most appropriate method depends on the area being treated, the suspected diagnosis, and the purpose of the injection. This will be discussed as part of your assessment and treatment plan.
An ultrasound-guided foot or ankle injection, or in some cases an X-ray-guided injection, may be considered for selected conditions such as arthritis, Morton’s neuroma, plantar fasciitis, ankle impingement, or other causes of persistent foot and ankle pain. It is usually considered after clinical assessment and after discussion of non-surgical options.
Depending on the clinical problem, an injection may be used to try to reduce pain, improve function, or help confirm which structure is responsible for symptoms. Relief following an image-guided injection can sometimes provide useful information when planning further treatment.
Many foot and ankle injections contain a mixture of local anaesthetic and corticosteroid. The local anaesthetic can numb the area for a short time, while the steroid aims to reduce inflammation and pain.
If you have had a previous reaction to local anaesthetic, steroid, skin preparation, dressings, or other medicines, you should tell your specialist before treatment.
In selected cases, other treatments may be considered, including platelet-rich plasma (PRP), prepared from a sample of your own blood. These injections are different from standard steroid injections and may be considered in selected situations depending on the condition being treated.
The effect of a foot or ankle injection depends on the condition being treated. Some patients obtain useful relief, while others notice little or no improvement. An ultrasound-guided injection or X-ray-guided injection should not be seen as a guaranteed solution, but it can be a helpful part of treatment for some foot and ankle problems.
How long the effect lasts can vary considerably. Some patients notice short-term improvement only, while others have relief for several months. In some cases, an image-guided injection may help delay or avoid surgery. In others, surgery may still be considered if symptoms continue.
Image-guided injection treatment is commonly performed and significant complications are uncommon, but no procedure is without risk.
Potential risks include:
Some injections are not suitable in certain areas because of the surrounding soft tissues and local risks. Whether an image-guided injection is appropriate depends on the condition, the site involved, your medical history, and the treatment goals.
There is no single answer. Some injections help for only a short time, while others may provide benefit for months. If symptoms improve and later return, it is useful to note how much relief you had and how long it lasted, as this can help guide future treatment.
You will usually be able to go home shortly after the procedure. Depending on the site injected and the treatment used, you may be advised to reduce impact activity for a short period. Specific aftercare advice will be given at the time of treatment.
An ultrasound-guided foot and ankle injection uses ultrasound imaging to help place the injection accurately into the intended area or around the intended structure in real time.
Foot and ankle injections are usually performed under ultrasound guidance or X-ray guidance, depending on the condition and the area being treated.
Depending on the clinical problem, injections may be considered for conditions such as arthritis, Morton’s neuroma, plantar fasciitis, ankle impingement, and other causes of persistent foot or ankle pain.
Many injections contain local anaesthetic and corticosteroid. In selected cases, other treatments such as platelet-rich plasma may be considered instead.
This varies. Some injections provide short-term relief only, while others may help for several months. The duration depends on the condition being treated and the individual response.
Risks can include pain after injection, temporary flare of symptoms, infection, bleeding or bruising, skin changes, injury to nearby structures, or return of symptoms over time.
In some cases, yes. An injection may reduce symptoms enough to delay or avoid surgery, but this is not the case for everyone and depends on the underlying condition.
Grice J, Marsland D, Smith G, Calder J. Efficacy of Foot and Ankle Corticosteroid Injections. Foot & Ankle International. 2017;38(1):8-13.
Hassouna H, Singh D, Taylor H, Johnson S. Ultrasound guided steroid injection in the treatment of interdigital neuralgia. Acta Orthopaedica Belgica. 2007;73(2):224-229.
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Goring Hall and
Nuffield Haywards Heath Private secretary: Nicole Murray Tel: 07856 521034 [email protected] |
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