Having a Joint Injection / Aspiration Department of Radiology Information for Patients i Radiology Leaflet No. 12
Contents Page number Introduction 3 Referral and consent 3 What is a joint injection? 3 What is a joint aspiration? 4 Important information 4 How to prepare for your joint injection or aspiration 4 What happens during the examination? 5 How long will it take? 5 Who will be doing the examination? 6 How do I get the results? 6 What happens after the examination? 6 Advice for patients who have had a steroid injection 6 Are there any risks? 7 Support for people with learning difficulties 8 Other sources of information 8 Additional hospital information 9 2
Introduction Please read your appointment letter carefully to check which hospital you must attend for your appointment. Referral and consent The doctor who referred you should have discussed the reasons for this procedure with you in the clinic. You should make sure that you understand these before you come for the procedure. You have been sent to a radiologist for this procedure. They are doctors who have trained and specialised in imaging and x-ray treatments. When you come to the radiology department for your procedure the radiologist will confirm that you understand why the procedure is being done, its potential risks, and what the chances of success are. You will then be asked to sign a consent form to confirm this. If the radiologist feels that your condition has changed or that your symptoms do not indicate that such a procedure is necessary then they will explain this to you and ask that you return to your referring doctor (e.g. your GP or consultant) for review. Your radiologist and referring doctor will be acting in your best interest at all times. What is a joint injection? A joint injection is an injection of local anaesthetic and/or steroid into a joint. Joint injections are usually carried out to treat inflammation and reduce pain/discomfort. 3
What is a joint aspiration? A joint aspiration is a way of removing a small amount of fluid from a joint using a needle and syringe. The fluid taken out of the joint can be sent for testing to help with the diagnosis of your condition. For example the fluid can be used to count the number of blood cells or to see if there is an infection in the joint. Joint injections and aspirations can be done on the shoulder, hip, knee, ankle, elbow, wrist, thumb and the small joints of the hands and feet. Important information If you are taking any medication that thins the blood please contact the radiology department for advice by phoning the number on your appointment letter. These medications might include warfarin, aspirin, heparin or Clopidogrel. If you are a diabetic patient and having a joint injection please tell the person performing your examination before it starts. This is because the steroid that is injected into your joint could affect your blood sugar level. How to prepare for your joint injection or aspiration Do not have anything to eat or drink for 2 hours before the appointment. You will need someone to drive you home after the examination. 4
What happens during the examination? On arrival at the Radiology Department you will be directed to the relevant waiting area and may be asked to change into a hospital gown. If you are having a knee or ankle injection/ aspiration you may wear short trousers. You will be taken into the x-ray or ultrasound room where the examination will be explained to you and you may ask any questions that you have. Sometimes x-rays may be taken of your joint before the procedure begins. You will be asked to lie down on the examination table. Your skin will be cleaned with antiseptic liquid and sterile towels will be placed over you. The radiologist will decide on the best way to place the needle into your joint in order to perform the injection or aspiration. This may be done using either ultrasound or x-rays to guide the needle into the joint. Local anaesthetic may be injected into the skin to numb the area. If x-rays are being used to guide the needle into your joint a small amount of contrast medium (a colourless liquid that shows up on x-rays) may be injected into the joint to check the position of the needle. If you are having a joint injection, some steroid (to reduce inflammation) and local anaesthetic may also be put into the joint at this point, if requested by the referring doctor. If you are having a joint aspiration a syringe will be used to remove some of the fluid from the joint. How long will it take? The time will vary for each patient. Most examinations take 20 40 minutes. 5
Who will be doing the examination? The examination will be performed by a radiologist. During the examination there will also be a radiographer and sometimes a nurse or assistant in the room. As we are a teaching hospital a student may also be present. If you wish you can request that the student is not present during your examination. How do I get the results? If you have had a joint aspiration the results will be given to you the next time you see the doctor who referred you for this examination. An explanation of how to get your results will be given to you following your examination. What happens after the examination? For a few hours after the examination your joint may feel uncomfortable. We may ask you to wait in the Radiology Department for a short time (15-30 minutes) after your examination. You will need someone to drive you home after the examination. Advice for patients who have had a steroid injection After a few days the local anaesthetic will wear off. It is important that you monitor and keep a record of any changes in your pain over the next few weeks. This information will be useful next time you see your consultant. Female patients who have periods may notice that their menstrual cycle is slightly irregular for a few months. Diabetic patients should monitor their blood sugar more closely over the next few days. Some patients may get facial flushing for a short time. 6
Are there any risks? A joint injection or aspiration is a common examination that has little risk, however there is a very small risk of an infection being introduced into the joint. Every precaution is taken to avoid infection. If the joint becomes red, warm or tender, or if you develop a fever in the first few days after the examination please see your GP. X-rays - The risk of having x-rays is very small indeed. We are all exposed to natural background radiation every day of our lives. This comes from the sun, food we eat, and the ground. Each examination gives a dose on top of this natural background radiation. The risks of radiation are slightly higher for the unborn child so we must ask female patients aged 10 to 55 years about their menstrual history. The radiation from the x-rays during a joint injection/aspiration is equivalent to receiving approximately a few weeks of natural background radiation. The benefits of this examination outweigh any potential risk and the risk from not having the examination could be greater. We will take all safeguards to minimise the amount of x-rays you receive. 7
Support for people with learning difficulties There is support available in our hospitals for patients with learning disabilities. Please contact the learning disability specialist nursing team on (0116) 258 4382 telling them when the appointment is and what examination has been booked. Other sources of information Websites: For general information about radiology departments visit the Royal College of Radiologists website: www.goingfora.com For information about the effects of x-rays read the NRPB publication: X-rays how safe are they, on the Health Protection Agency website: www.hpa.org.uk Please note that the views expressed in these websites, do not necessarily reflect the views of UHL or the NHS. University Hospitals of Leicester website: www.leicestershospitals.nhs.uk NHS Direct: For health advice or information you can call NHS on: 111. 8
Additional hospital information How was it for you? If you wish to make any comments or suggestions regarding your visit to the Radiology Department please fill in a suggestion form or speak to a member of staff. Suggestion forms are located in all waiting areas within the department. University Hospitals of Leicester NHS Trust also has a Patient Information and Liaison Service (PILS), and you are welcome to contact them on: Freephone: 08081 788337 email: pils.complaints.compliments@uhl-tr.nhs.uk We review our information leaflets on a regular basis. If you have any comments about how we can improve these leaflets please speak to a member of staff. 9
Additional hospital information (continued) Directions and parking For information about getting to the hospital please see the hospitals website: www.leicestershospitals.nhs.uk/patients/getting-to-hospital Hospital car parking is available to all hospital patients and visitors. Spaces are limited so please allow plenty of time to find a car parking space. Parking charges are payable, please check tariff boards or the hospital website for full details. As well as the hourly rates there are a range of saver tickets available for patients and prime carers. Dedicated disabled parking bays are also available. Marked disabled bays exist outside of the public car parks for which there is no charge. If you park in the car parks the fee will apply. Drop off bays exist at the main entrances, these bays have a 20 minutes maximum stay. Certain qualifying benefits as notified by the Department of Social Security entitle the patient to free or reduced parking. For more information contact the Cashiers office. Bus services to the hospital For information on bus routes and times contact Traveline on 0871 200 2233. The hospital Hopper service runs from Monday to Friday, every 30 min from 06:30 hours until 18:00 hours and every hour from 18:00 hours until 21:00 hours. The Hopper stops at our three hospital sites, as well as other key locations such as Leicester train station, Beaumont Leys centre and Hamilton centre and also St Nicholas circle. www.leicestershospitals.nhs.uk/patients/getting-to-hospital/bustravel/hospital-hopper-bus/ 10
Additional hospital information (continued) Relatives and escorts You may wish to bring a friend or relative to accompany you to and from the Radiology Department when you have your examination although they may not always be allowed into the examination room. This may be useful if you do not understand English very well or if you have any special needs. Children Baby changing facilities are available. Please ask to be shown to them if you wish to use them. We are unable to offer childcare facilities. If you need to bring your children with you, please bring along an adult who can supervise them whilst your examination is being carried out. Radiology staff are not able to supervise your children. Facilities available: Refreshments: Refreshments including hot and cold drinks are available in the hospital. Please ask a member of staff for directions. Shops: Each hospital contains a shop selling magazines, newspapers, sweets and drinks. Please ask a member of staff for directions. This leaflet has been produced with reference to guidelines from the Royal College of Radiologists. 11
Produced by: Imaging Patient Information Group CSI. Edition 5. Leaflet Produced : December 2016. Next Review: December 2021. (Mear)IMA039-1216 Today s research is tomorrow s care We all benefit from research. Leicester s Hospitals is a research active Trust so you may find that research is happening when you visit the hospital or your clinic. If you are interested in finding out how you can become involved in a clinical trial or to find out more about taking part in research, please speak to your clinician or GP. If you would like this information in another language or format, please contact the service equality manager on 0116 250 2959