General Introduction On Imaging Guided Interventions

  • Jan L. M. A. GielenEmail author


This chapter is a review upon interventional procedures for the musculoskeletal system. General technical principles and indications for diagnostic or therapeutic purposes will be discussed. An overview of techniques and approaches, choice of equipment, choice and quantity of pharmaceuticals, appropriate aftercare as well as possible procedure-related sequellae and their treatment and adverse effects of medications are discussed.



Computed tomography


Magnetic resonance imaging


Non-steroidal anti-inflammatory drug


Percutaneous needle tenotomy


Platelet-rich plasma treatment


Region of interest




Visual analog scale


  1. 1.
    Andres BM, Murrell GAC. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 2008;466(7):1539–54.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Ayral X. Injections in the treatment of osteoarthritis. Best Pract Res Clin Rheumatol. 2001;15:609–26.CrossRefPubMedGoogle Scholar
  3. 3.
    Balch HW, Gibson JM, El-Ghobarey AF, Bain LS, Lynch MP. Repeated corticosteroid injections into knee joints. Rheumatol Rehabil. 1977;16:137–40.CrossRefPubMedGoogle Scholar
  4. 4.
    Banks AR. A rationale for prolotherapy. J Orthop Med. 1991;13:54–9.Google Scholar
  5. 5.
    Bertrand H, Reeves KD, Bennett CJ, Bicknell S, Cheng AL. Dextrose prolotherapy versus control injections in painful rotator cuff tendinopathy. Arch Phys Med Rehabil. 2016;97(1):17–25.CrossRefPubMedGoogle Scholar
  6. 6.
    Boyer MI, Hastings H II. Lateral tennis elbow: “is there any science out there?”. J Shoulder Elb Surg. 1999;8(5):481–91.CrossRefGoogle Scholar
  7. 7.
    Chen LC, Ho CW, Sun CH, Lee JT, Li TY, Shih FM, Wu YT. Ultrasound-guided pulsed radiofrequency for carpal tunnel syndrome: a single-blinded randomized controlled study. PLoS One. 2015;10(6):e0129918.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Chen MJ, Lew HL, Hsu TC, Tsai WC, Lin WC, Tang SF, Lee YC, Hsu RC, Chen CP. Ultrasound-guided shoulder injections in the treatment of subacromial bursitis. Am J Phys Med Rehabil. 2006;85(1):31–5.CrossRefPubMedGoogle Scholar
  9. 9.
    Coombes BK, Bissel L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomized controlled trials. Lancet. 2010;376(9754):1751–67.CrossRefPubMedGoogle Scholar
  10. 10.
    Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64:465–74.CrossRefGoogle Scholar
  11. 11.
    Jaffe JD, Henshaw DS, Nagle PC. Ultrasound-guided continuous superficial peroneal nerve block below the knee for the treatment of nerve injury. Pain Pract. 2013;13(7):572–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Jankovic D, Peng P, van Zundert A. Brief review: piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth. 2013;60(10):1003–12.CrossRefPubMedGoogle Scholar
  13. 13.
    Jung H, Jeon S, Ahn S, Kim M, Choi Y. The validation of ultrasound-guided lumbar facet nerve blocks as confirmed by fluoroscopy. Asian Spine J. 2012;6(3):163–7.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Keagy RD, Keim HA. Intra-articular steroid therapy: repeated use in patients with chronic arthritis. Am J Med Sci. 1967;253:45–51.CrossRefPubMedGoogle Scholar
  15. 15.
    Lee DH, Seung-Beom H, Park JW, Soon-Hyuck L, Kwan-Woo K, Woong-Kyo J. Sonographically guided tendon sheath injections are more accurate than blind injections: implications for trigger finger treatment. J Ultrasound Med. 2011;30(2):197–203.CrossRefPubMedGoogle Scholar
  16. 16.
    Liu YK, Tipton CM, Matthes RD, Bedford TG, Maynard JA, Walmer HC. An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligaments and its junction strength. Connect Tissue Res. 1983;11(2–3):95–102.CrossRefPubMedGoogle Scholar
  17. 17.
    Luck JL. Musculoskeletal ultrasound intervention, principles and advances. Radiol Clin N Am. 2008;46:515–33.CrossRefGoogle Scholar
  18. 18.
    MacMahon PJ, Huang AJ, Palmer WE. Spine injectables: what is the safest cocktail? Am J Roentgenol. 2016;207:1–8. [Epub ahead of print].CrossRefGoogle Scholar
  19. 19.
    Maxwell NJ, Ryan MB, Taunton JE, Gillies JH, Wong AD. Sonographically guided intratendinous injection of hyperosmolar dextrose to treat chronic tendinosis of the Achilles tendon: a pilot study. Am J Roentgenol. 2007;189(4):W215–20.CrossRefGoogle Scholar
  20. 20.
    Ohberg L, Alfredson H. Ultrasound guided sclerosis of neovessels in painful chronic Achilles tendinosis: pilot study of a new treatment. Br J Sports Med. 2002;36(3):173–5. [discussion 176–7].CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Ostergaard M, Halberg P. Intra-articular corticosteroids in arthritic disease: a guide to treatment. BioDrugs. 1998;9:95–103.CrossRefPubMedGoogle Scholar
  22. 22.
    Park Y, Lee SC, Nam HS, Lee J, Nam SH. Comparison of sonographically guided intra-articular injections at 3 different sites of the knee. J Ultrasound Med. 2011;30(12):1669–76.CrossRefPubMedGoogle Scholar
  23. 23.
    Schneider C. Traumeel—an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med. 2011;4:225–34.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Speed CA. Fortnightly review: corticosteroid injections in tendon lesions. BMJ. 2001;323(7309):382–6.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Taheri A, Hatami M, Dashti M, Khajehnasiri A, Ghajarzadeh M. Effect of ultrasound guided subsartorial approach for saphenous nerve block in cases with saphenous nerve entrapment in adductor canal for controlling chronic knee pain. Middle East J Anaesthesiol. 2015;23(1):25–8.PubMedGoogle Scholar
  26. 26.
    Tehranzadeh J, Booya F, Root J. Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol. 2005;46(3):288–96.CrossRefPubMedGoogle Scholar
  27. 27.
    Thumboo J, O’Duffy JD. A prospective study of the safety of joint and soft tissue aspirations and injections in patients taking warfarin sodium. Arthritis Rheum. 1998;41:736–9.CrossRefPubMedGoogle Scholar
  28. 28.
    YT W, Ho CW, Chen YL, Li TY, Lee KC, Chen LC. Ultrasound-guided pulsed radiofrequency stimulation of the suprascapular nerve for adhesive capsulitis: a prospective, randomized, controlled trial. Anesth Analg. 2014;119(3):686–92.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of RadiologyUniversity Hospital AntwerpAntwerpBelgium
  2. 2.Department of MorphologyUniversity of AntwerpAntwerpenBelgium

Personalised recommendations