What Are Joint Injections?
Joint injections deliver therapeutic medication directly into the joint space, where it works most effectively at the source of pain and inflammation. By bypassing the systemic circulation and targeting the joint directly, injections achieve a higher local concentration of medication with fewer body-wide side effects than oral treatments. Dr. Qureshi performs all joint injections under ultrasound or fluoroscopic image guidance to confirm accurate intra-articular placement before delivering medication — a critical distinction that significantly improves efficacy and safety compared to unguided approaches.
Studies consistently demonstrate that ultrasound-guided joint injections achieve confirmed intra-articular placement in over 95% of cases, compared to approximately 60% accuracy for unguided approaches to the hip, and 70–80% for the shoulder. The clinical implication is straightforward: accurate placement means more medication reaches the joint space, producing better and more reliable outcomes. At our Katy practice, image guidance is standard for every joint injection.
Types of Joint Injections
Corticosteroid Injections
Corticosteroid (cortisone) injections remain the most widely used joint injection, with decades of evidence supporting their use for inflammatory joint conditions. The corticosteroid reduces intra-articular inflammation by suppressing prostaglandin and cytokine production, decreasing synovial fluid production, and reducing the sensitivity of inflammatory pain receptors. Local anesthetic is combined in most cases, providing immediate temporary relief that confirms accurate needle placement while the steroid begins its delayed anti-inflammatory effect over 3–5 days.
Hyaluronic Acid (Viscosupplementation)
Hyaluronic acid (HA) injections — often called "gel injections" — supplement the naturally occurring hyaluronic acid in synovial fluid that provides lubrication and shock absorption in healthy joints. In osteoarthritic joints, hyaluronic acid concentration and molecular weight decrease, reducing joint lubrication efficiency. HA injections partially restore this function and also have direct anti-inflammatory and potentially chondroprotective effects. They are primarily used for knee osteoarthritis (Grades 1–3) and have the strongest evidence base in this indication.
Platelet-Rich Plasma (PRP)
PRP joint injections deliver concentrated growth factors from your own blood into the joint space to stimulate cartilage repair and reduce inflammation through biological mechanisms. Unlike corticosteroid, PRP actively promotes tissue repair rather than symptom suppression, and its effect develops more gradually but typically lasts significantly longer. Growing evidence supports PRP for knee, hip, and shoulder osteoarthritis as a longer-term alternative or complement to corticosteroid.
Joints Treated
- Knee — osteoarthritis, meniscal-related synovitis, inflammatory flares; ultrasound-guided for confirmed intra-articular placement
- Hip — osteoarthritis, labral-related synovitis, trochanteric bursitis; fluoroscopic guidance required given the deep anatomy
- Shoulder — glenohumeral arthritis, frozen shoulder, subacromial bursitis; ultrasound guidance preferred
- Sacroiliac (SI) joint — SI joint arthritis and dysfunction; fluoroscopic guidance with contrast confirmation
- Facet joints — lumbar and cervical facet arthritis; fluoroscopic guidance
- Acromioclavicular (AC) joint — AC joint arthritis causing top-of-shoulder pain
- Ankle — tibiotalar arthritis and chronic ankle pain
The Procedure
Joint injection procedures are brief and performed in our on-site procedure suite. The target area is cleaned with antiseptic, the skin is numbed with local anesthetic, and the injection needle is placed under real-time ultrasound or fluoroscopic visualization. For fluoroscopic procedures, contrast dye confirms accurate intra-articular placement before medication is delivered. The entire procedure typically takes 10–15 minutes. You rest briefly in the recovery area and can drive home unless sedation was used.
Before and After Your Injection
You do not need to fast before a joint injection. Wear comfortable clothing that allows access to the injection site. Blood thinners should be discussed with Dr. Qureshi's office in advance. After the injection, you may experience a mild post-injection flare lasting 24–48 hours as the local anesthetic wears off before the corticosteroid takes effect. Ice, rest, and over-the-counter anti-inflammatories manage this comfortably in most patients. Resume normal activities the following day.