Advice after your nerve block for surgery
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Introduction
We have been advised by your hospital consultant that you need to have a musculoskeletal injection performed in the Radiology (X-ray) Department under imaging control. This information tells you about the procedure, what is involved, and what the possible risks are.
We will use one or more types of radiology method to guide the needle into the correct place in the body. The injection may therefore take place in the CT, Ultrasound and/or Fluoroscopy Departments within Radiology.
An arthrogram better visualises the internal structure of a joint and requires the contrast (X-ray dye containing iodine) to be injected into the joint under radiological view.
The procedure will be performed by a radiologist (doctor specialising in medical imaging) who may be assisted by a radiographer and / or a radiology nurse.
What is a CT scan?
A CT scan is an examination using X-rays by lying on a flat table inside a scanner that
produces detailed cross sectional images of your body. These images are cross-sectional (like slices) and are used to produce 2D and 3D images of the body’s organs
What is Fluoroscopy?
Fluoroscopy is a process that uses X-rays to produce a real time moving image on a
television monitor.
What is Ultrasound?
An ultrasound scan is an examination that uses sound waves to take pictures of the part of the body being examined. It does not involve X-rays.
Which imaging modality used will depend upon the location, type and accessibility of the tissue to be biopsied, and will be decided by the radiologist before your appointment is made.
Before your appointment
Please let us know if:
- there is any chance of you being pregnant
- you are taking any medication
- you are on medication that suppresses your immune system eg methotrexate or beta interferon, or steroids.
- you have an infection or any other medical condition which may mean we need to reschedule this appointment
- you will need an interpreter. We are not able to use family members or friends to interpret.
In order to make your appointment run more smoothly, please let us know if any of these apply, in advance, by calling our bookings team (contact details are displayed on the main Radiology page).
On Arrival
Please arrive 10 minutes before your appointment time.
On arrival in the department you should check in at the reception desk. Bring this letter with you and be prepared to confirm your details with the receptionist. All patients from 12-55 years of age (regardless of gender) who will undergo a Radiology procedure will be asked about the possibility of them being pregnant. Please allow time to do this prior to your appointment time and bear in mind that the reception may be busy. Once you have been booked in you will be directed to the waiting area. Please be aware that patients are attending for different examinations and patients who arrive after you may be called before you.
What to wear
Please wear comfortable clothing that allows easy access to the area of the body to be injected. We may ask you to change into a hospital gown, if needed.
Giving my consent (permission)
We want to involve you in decisions about your care and treatment. The radiologist will ask you if you are happy for the procedure to go ahead - this is called verbal consent. If you do not wish to have the scan or are undecided, please tell the sonographer/radiologist. It is your decision and you can change your mind at any time.
If the radiologist feels that your condition has changed or that your symptoms do not indicate such a procedure is necessary then they will explain this to you and they will communicate with the referring doctor who will review your situation as soon as possible.
The Procedure
After positioning on an examination couch, the area being examined will be exposed and a scan will identify the correct location for the injection. Where appropriate your skin will be numbed with local anaesthetic. When the local anaesthetic is injected, it will sting to start with, but this soon wears off, and the skin and deeper tissues should then feel numb. The imaging will be used to guide a needle to the correct position and a steroid or contrast will be injected.
If the procedure is an arthrogram you may be taken to the CT scanner for a scan of the joint to be obtained.
After the Examination
You will be free to resume your daily activities. Steroid injections can take a few days to have a noticeable effect. The steroid lasts for up to six weeks but the effects of the injection can sometimes last much longer.
Risks
- Discomfort: You may experience some discomfort immediately after the procedure. This is usually mild and can be helped with over-the-counter painkillers if required. Occasionally steroid injections can worsen your symptoms temporarily (steroid flare).
- Bleeding: Any injection carries a small risk of bleeding particularly if you are on anticoagulant or antiplatelet medication. On very rare occasions, this may become severe.
There may be some bruising around the injection site but this is unlikely to cause you a problem. - Infection: If you experience redness, swelling or tenderness around the injection site, please see your GP or a walk-in clinic within 24 hours as this may require treatment.
- Glucose control: If you are diabetic and require insulin, you may experience low or high blood glucose levels after a steroid injection. Please monitor this closely after the procedure until it returns to your normal pattern.
- Facial flushing: This is not common. If this does happen, it is temporary and typically goes away within a couple of days.
- Skin depigmentation: Occasionally steroid injections can cause the skin around where the needle has been inserted to become slightly paler in colour.
Contact us
If you have any queries relating to this information, please contact the Radiology service.
About this information
Service:
Radiology
Reference:
PILS-IR.9
Approval date:
3 October 2024
Review date:
3 October 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.