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Ultrasound-Guided Hyaluronic Acid Injections in London

Viscosupplementation for osteoarthritis — hyaluronic acid placed into the affected joint under real-time ultrasound guidance. Carried out at our Marylebone clinic. From £250.

Real-time ultrasound guidance
Consultant radiologist
No radiation
Marylebone, W1G

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 hyaluronic acid does

Your body makes hyaluronic acid naturally. It is part of the fluid that lubricates your joints and helps them absorb load, keeping them moving smoothly.

In osteoarthritis, the hyaluronic acid in the affected joint becomes thinner. A hyaluronic acid injection — sometimes called viscosupplementation — adds to your body's natural supply. Where it works, it can reduce joint pain and improve the environment at the joint surfaces.

When effective, the benefit can last for many months, sometimes beyond six months, and in some cases up to a year.

Why guidance is used

  • Accuracy. The needle is tracked in real time into the joint space.
  • Safety. Nerves, vessels and tendons are visible and can be avoided.
  • Volume matters. Hyaluronic acid is a larger, gel-like volume, so correct placement is important.
  • No radiation. Ultrasound uses sound waves, unlike fluoroscopy.

Who hyaluronic acid injections are offered to

No clinician can predict in advance who will benefit. In practice, these injections are usually considered for people with osteoarthritic joints who:

Activity

Want to stay active

People who are active and want to maintain that, where symptoms have not settled with non-drug measures such as exercise, heat or ice.

Medication

Cannot take painkillers

Those who have not improved on paracetamol, ibuprofen, naproxen or other anti-inflammatories — or who cannot take them at all.

Surgery

Want to avoid surgery

People who do not want, or are not suitable for, an invasive surgical procedure at this stage.

How effective are they?

Studies suggest hyaluronic acid injections may work better than painkillers for some people with osteoarthritis, and some evidence indicates they can work as well as corticosteroid injections in the knee. Response varies considerably between individuals.

From our practice

Who tends to respond, and who tends not to

Robert Mast, Consultant Radiologist, observes that patients whose pain is brought on by load bearing or activity tend to respond more favourably than those with high levels of pain even at rest.

In that second group — where pain is present without mechanical loading — a steroid injection, where clinically appropriate, is more likely to reduce symptoms. Which is right for you is discussed after the diagnostic scan rather than decided in advance.

Clinical observation from our practice, shared by Robert Mast, Consultant Radiologist.

An honest expectation

Viscosupplementation is not a cure for osteoarthritis and does not reverse joint changes. Where it helps, it reduces pain for a period — often long enough to keep moving and stay active, which is where most of the longer-term benefit comes from.

What happens during the injection

1
Positioning and preparationYou are placed in a comfortable position and the skin over the joint is cleaned with antiseptic.
2
Guided placementA needle is positioned into the affected joint while the procedure is monitored with ultrasound guidance, so placement can be seen rather than assumed.
3
InjectionThe hyaluronic acid is injected through the needle. A plaster is placed over the site to keep it clean.
4
AfterwardsSome discomfort for a few days afterwards is possible. Your clinician will give aftercare advice specific to the joint treated.

Is it painful?

The injection is not particularly painful, though because the volume injected is larger and the fluid has a gel-like consistency, it can feel slightly more uncomfortable than a steroid injection. The clinician performing it is thoroughly trained in the procedure. Some people have several days of discomfort afterwards.

Before your appointment

You will be sent an information leaflet on hyaluronic acid injections — please read it carefully. You will also be asked to complete and return a short questionnaire about your general health, so we can be confident the treatment is right for you.

Who performs the injection, and how it is arranged

Who carries it out

Your injection is 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.

Pricing

Ultrasound-guided hyaluronic acid injections start from £250. The exact cost depends on the joint being treated and the product used, 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 the diagnosis and whether an injection is appropriate.
  • See all fees on our price list.
Talk to us first

We will confirm whether hyaluronic acid is the right option for you, who will carry it out and the cost, before anything is arranged.

Frequently asked questions

How long does the benefit last?+
Where the injection works, benefit can last many months — sometimes beyond six months, and in some cases up to a year. Response varies considerably between individuals, and not everyone benefits.
Hyaluronic acid or cortisone — which is 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