Fluoroscopic guided injection is a procedure that uses low dose x-radiation, to guide a needle into the exact area where the injection is needed. The procedure uses a special dye (contrast) that shows up on the images, it does not remain in your joint.
We require you to contact the department if any of the following apply to you, if the department is not contacted before the appointment and any are applicable to you the appointment may be cancelled:
- You are taking anti-coagulants (blood thinning medication) such as Warfarin, Aspirin, Clopidgrel, Rivaroxaban or Apixaban
- If you have recently been diagnosed with a DVT or a suspected DVT and your medication is still ongoing.
- You are on or have recently been taken off Antibiotics
- If you have had a reaction to contrast in the past
- You have a concern you may have an infection
- Any allergies to medications.
Contact number: 020 3947 0040
Please book in at reception when you arrive at the X-ray department.
We advise you to bring someone with you if necessary as you will not be allowed to drive following the procedure.
After booking in you will be asked to take a seat. Please be aware that we run a busy service with multiple procedures, so patients will be taken into separate rooms at different times.
You will be asked into the room where a nurse / helper / radiographer will help you change if required. They are there to help with the procedure and ensure you are at ease throughout.
The radiologist will carry out the procedure. If you have a latex allergy please inform the staff in the room.
The procedure is a simple x-ray to start, this is to locate the area the injection needs to be placed in. Once the correct location has been found the radiologist will use a permanent marker to mark the injection site.
The second part of the procedure uses an aseptic (clean) technique to reduce the risk of infection. Your skin will be washed and a sterile cover will be placed over the injection site. A needle will be used to inject a local anaesthetic +/- a steroid into the area where you have your pain. Local anaesthetic will be injected initially to numb the area, which will sting first for a couple of seconds before it goes numb.
The needle will be positioned at the specified site using the fluoroscopy machine for guidance. The local anaesthetic / local anaesthetic and steroid mixture will then be injected. A dressing will be applied at the end of the procedure and needs to be kept clean and dry for the rest of the day.
You should avoid strenuous activity for a few days after the procedure. The area that has been injected may be sore for a few days. Normal pain medication can be taken as usual.
Following the injection, the local anaesthetic will begin to wear off after 1 to 2 hours. You may experience worsening symptoms during the first 24 to 48 hours, this is due to the steroid, which is called a steroid flare. Your normal pain control may be taken, if the pain is severe or increasing after the first 48 hours please seek medical help.
You might be given a pain diary to record your pain levels to take with you to your next consultant appointment.
For diabetics a rise in blood sugar levels may occur for a few days after the procedure.
Steroid injections can occasionally cause some thinning / changes in the colour of the skin at the injection site, especially if they are repeated.
Medical help via your GP / local minor injuries unit should be sought if there are any signs of the following:
- Excessive bleeding from the site
- Increased pain, swelling, redness or warmth
- Swelling in the neck, armpit or groin
- Fever / chills
If you are unable to attend this appointment please let the department know ASAP, the appointment can be used by another patient.
- X-Ray / Ultrasound MRI / CT / Nuclear Medicine: 020 3947 0040
- DXA: 020 8909 5476
- Pre operative assessment: 020 8909 5630
Page last updated: 17 February 2025