Intra-Articular Injections

What is an Intra-Articular Injection?

An intra-articular injection places medication directly inside the joint capsule, delivering a high local concentration of therapeutic agent to the inflamed synovium, cartilage, and surrounding structures while minimising systemic exposure. We use ultrasound or fluoroscopic image guidance to confirm accurate placement: entering a joint accurately without imaging depends on surface anatomy and can be unreliable in swollen, distorted, or deep joints. The medication used depends on the clinical indication: corticosteroid reduces acute synovial inflammation, hyaluronic acid supplements depleted joint fluid in osteoarthritis, and PRP delivers growth factors to support tissue repair.

The joint is accessed through a standardised approach specific to each joint’s anatomy. For the knee, this is typically the superolateral or medial approach. For the shoulder glenohumeral joint, a posterior approach is standard. The hip and sacroiliac joint require imaging guidance given their depth and proximity to vascular and neural structures.

What conditions does it treat?

Intra-articular injections benefit any condition where joint inflammation, synovitis, or cartilage degeneration is generating pain. We use them most commonly for knee osteoarthritis, shoulder arthritis and frozen shoulder (adhesive capsulitis), hip joint pain, and sacroiliac joint dysfunction. They are also used for acute flares of inflammatory arthritis and for joint pain following sports injuries where the intra-articular structures are involved.

What to expect

Before: Tell us about any blood thinners, antibiotics you are currently taking, or active infections near the joint. For deep joints such as the hip, you may be asked to fast lightly before the procedure in case sedation is used.

During: The skin is cleaned and a local anaesthetic is applied. Under image guidance, a fine needle is advanced into the joint space. You may feel a brief pressure or mild sting as the needle enters. The injection itself takes under a minute. The full appointment including preparation and post-procedure monitoring is typically 30 to 45 minutes.

After: Mild soreness and swelling at the injection site for 24 to 48 hours is normal. Rest the joint lightly for the first day. Steroid injections typically produce noticeable relief within 3 to 5 days, lasting weeks to months. Hyaluronic acid injections build effect over several weeks. A course of injections is often combined with physiotherapy to maintain joint function between treatment cycles.