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Ultrasound-Guided Cortisone Injection in London

Medically reviewed by Robert Mast, Consultant Radiologist —

Targeted anti-inflammatory injection placed under real-time ultrasound guidance, for joint, tendon and bursa pain. Carried out at our Marylebone clinic by a consultant radiologist. From £250.

Real-time ultrasound guidance
Consultant radiologist
No radiation
Marylebone, W1G
Enquire About an Injection Call 020 3633 4902

Injections are arranged rather than booked online, so we can confirm suitability, who will carry out the procedure and the cost with you first.

What is an ultrasound-guided cortisone injection?

A cortisone injection delivers a corticosteroid — a strong anti-inflammatory medicine — directly into an inflamed joint, tendon sheath or bursa to reduce inflammation and relieve pain.

The difference with ultrasound guidance is visibility. A traditional injection relies on surface landmarks felt through the skin. With ultrasound, the clinician watches the needle on screen as it advances, so the medicine is placed in the intended space rather than near it.

Why guidance is used

  • Accuracy. The needle is tracked in real time to the target structure.
  • Safety. Nerves, vessels and tendons are visible and can be avoided.
  • Comfort. Fewer passes are usually needed to reach the target.
  • No radiation. Ultrasound uses sound waves, unlike fluoroscopy.

What the evidence shows

Ultrasound guidance improves the accuracy of needle placement compared with unguided injection. That is the claim the evidence supports well. How much symptom relief you get, and how long it lasts, still varies considerably between people — and is discussed with you beforehand rather than promised.

An honest expectation

A cortisone injection is a window of relief, not a cure. It is most useful when it reduces pain enough to let you engage with rehabilitation or physiotherapy, which is where longer-term improvement usually comes from.

Conditions commonly treated

Joints

Osteoarthritis

Inflammatory flares in joints such as the knee, hip and shoulder, where pain limits movement and rehabilitation.

Tendons

Tendinopathy and tenosynovitis

Rotator cuff, Achilles and patellar tendon problems, tennis and golfer's elbow, and trigger finger or thumb.

Bursae & nerve

Bursitis, carpal tunnel, plantar fasciitis

Subacromial, trochanteric and olecranon bursitis; inflammation around the median nerve at the wrist; plantar fascia pain in the heel.

Not sure whether an injection is the right step? A diagnostic MSK ultrasound comes first, so the decision is based on what the scan actually shows.

What to expect

1
BeforeThe procedure is explained, your questions answered and consent taken. You are positioned comfortably and the skin is cleaned with antiseptic.
2
DuringLocal anaesthetic numbs the skin. The needle is advanced under ultrasound to the target and the medicine is injected. You may feel pressure; significant pain is uncommon. Typically 15–30 minutes.
3
AfterwardsLocal anaesthetic often gives immediate short-lived relief. The corticosteroid usually starts working over 2–3 days, with fuller effect by 7–14 days.
4
RecoveryAvoid strenuous activity for the rest of the day. Light activity can usually resume after 24–48 hours, increasing as pain allows.

Worth knowing

  • A temporary increase in pain for 24–48 hours — a “steroid flare” — is not uncommon and is usually managed with simple pain relief and ice.
  • Injections into the same site are generally limited to two or three a year, to reduce the risk of tendon weakening or skin thinning.
  • If you have diabetes, corticosteroid can temporarily raise blood sugar, so monitoring is discussed in advance.
  • Injections are avoided where there is active infection at or near the site. Tell us about allergies and any blood-thinning medication.

Who performs the injection, and how it is arranged

Who carries it out

Ultrasound-guided injections are carried out by Robert Mast, Consultant Radiologist, or by an MSK radiologist when available.

How it is arranged

Sonoworld provides the diagnostic ultrasound and the assessment. The injection itself is delivered by a partner service, at our Weymouth Street premises. Contact us and we will explain the process, who will carry out the procedure and the cost — from £250 — before anything is arranged.

From our practice

Why guidance matters most in the shoulder

Subacromial bursitis in active adults — often people whose work or sport involves repeated overhead movement — is among the conditions most frequently referred for a guided injection. The anatomy in that space is complex, and a palpation-guided injection relies on surface landmarks rather than direct vision.

Real-time ultrasound lets the needle be tracked as it advances, so the medicine reaches the intended space. Accuracy of placement is what guidance improves. The degree and duration of relief still varies between patients, which is why we discuss it beforehand rather than promise an outcome.

General practice patterns from our clinic, not an individual patient case.

Pricing

Ultrasound-guided injections start from £250. The exact cost depends on the site and what is involved, and is confirmed with you before anything is arranged — there is no obligation.

A diagnostic scan usually comes first

  • MSK ultrasound from £235 — instant verbal results, written report within 24 hours.
  • The scan confirms whether inflammation is present and whether an injection is appropriate.
  • See all fees on our price list.
Talk to us first

We will confirm whether an injection is suitable, who will carry it out and the cost, before anything is arranged.

Request a Call Back Call the Clinic

Frequently asked questions

Does a cortisone injection hurt?+
Local anaesthetic is used to numb the skin first, so most people feel pressure rather than sharp pain. Because the needle is guided on ultrasound, fewer passes are usually needed to reach the target, which tends to make the procedure more comfortable than an unguided injection.
How long does it take to work?+
The local anaesthetic often gives immediate but short-lived relief. The corticosteroid itself usually begins working within two to three days, with fuller effect by seven to fourteen days. A temporary flare of pain in the first 24 to 48 hours is common and settles.
How long does the relief last?+
It varies considerably — from several weeks to several months — depending on the condition, the site and how the underlying problem is managed afterwards. Injections tend to work best when the relief is used to progress with physiotherapy or rehabilitation.
How many injections can I have?+
Injections into the same joint or area are generally limited to two or three per year, to reduce the risk of tendon weakening or thinning of the skin. Your specialist will discuss an appropriate interval and a longer-term plan for your condition.
Do I need a scan before an injection?+
Usually yes. A diagnostic MSK ultrasound confirms whether inflammation is present and whether an injection is the right treatment, so the decision is based on what the scan shows rather than symptoms alone.
Can I book an injection online?+
No — injections are arranged rather than booked online. Sonoworld provides the diagnostic ultrasound and assessment, and the injection is delivered by a partner service at our Weymouth Street premises. Contact us and we will explain the process, who will carry out the procedure and the cost before anything is arranged.
Considering an ultrasound-guided injection?Talk to us about whether it is suitable. We will confirm the process, who carries it out and the cost — from £250 — before anything is arranged. 29 Weymouth Street, Marylebone, London W1G 7DB.
Enquire Now 020 3633 4902

References

  • Cho C, et al. A prospective double-blind randomised trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder. The Bone & Joint Journal, 2021.
  • Paskins Z, et al. Clinical effectiveness of one ultrasound-guided intra-articular corticosteroid and local anaesthetic injection in addition to advice and education for hip osteoarthritis (HIT trial). The BMJ, 2022.
  • Daniels EW, et al. Existing evidence on ultrasound-guided injections in sports medicine. Orthopaedic Journal of Sports Medicine, 2018.
Care Quality Commission — Inspected and rated Good British Medical Ultrasound Society (BMUS) Information Commissioner's Office (ICO) Health and Care Professions Council (HCPC)
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