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Bursa Injections

Ultrasound Guided Cortisone Injections for Bursae and Soft Tissue

A bursa is a fluid filled sac located around the joints, usually between a tendon and the bone. This sac contains a lubricating fluid that acts as a cushion to reduce the friction during movement. Advancing age and excessive wear and tear may result in inflammation of the bursa and loss of its lubrication ability. This condition is known as bursitis and can result in painful movements of the affected joint.

Your doctor may recommend immobilization of the affected joint, medications and physical therapy as an initial step for the management of bursitis. If the symptoms persist after the initial treatment, your doctor may recommend a cortisone injection. During this procedure, the skin over the affected region is sterilized with an antiseptic solution, followed by topical application of a local anesthetic. Under ultrasound guidance, a fine needle is inserted into the bursa and a local anesthetic mixed with cortisone is injected into the area of inflammation. The needle is then withdrawn and the injection site is covered with a sterile bandage. Ultrasound guidance helps in accurate placement of the needle. This treatment usually results in rapid pain relief.

Most bursae of the body, such as subacromial (shoulder), trochanteric (lateral hip), iliopsoas (anterior hip), ischial (buttock), intermetatarsal (forefoot), prepatellar and infrapatellar (knee), and retrocalcaneal and retroachilles (Achilles tendon) may require repetitive injections.

The potential side effects of a cortisone injection include facial flushing, local side effects, increased pain, infection, elevated blood sugar level in diabetic patients, skin pigmentation, loss of fatty tissue, and tendon rupture.