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Diagnostic Musculoskeletal Ultrasound

Cortisone Shot

At times this can completely relieve symptoms or provide a ‘window’ of pain relief, allowing physiotherapy to be more effective. Normally, only one shot is required to gain sufficient pain relief and restore the normal range of movement. Neil Liffen treatments are performed under ultrasound guidance to visually guide the needle tip to the precise location to ensure the accuracy of the medication to the affected and/or desired joint or soft tissue.

Common complaints that can be effectively treated with cortisone shots include:

  • Osteoarthritis.
  • Bursitis.
  • Adhesive capsulitis/frozen shoulder.
  • Acromioclavicular joint sprain.
  • Tennis elbow (lateral epicondylitis).
  • Golfer’s elbow (medial epicondylitis).
  • Trigger finger/thumb.
  • Carpal Tunnel Syndrome.
  • De Quervain’s.
  • Hip joints.
  • Ankle and subtalar joints.
  • Plantar fasciitis/fasciopathy.
  • Mortons neuroma.

Hyaluronic Acid Shots

Hyaluronic acid shots are normally used for the treatment of osteoarthritis by reducing pain and improving the function of our joints and theoretically can be applied to any joint, especially the knee joint.

From one course, you can expect potential relief for 9-12 months. Ostenil (hyaluronic acid) is widely used in Sports Medicine and is used by most UK premiership Football clubs, Rugby clubs, Cricket clubs and the British Olympic Association. The shots can be used on a regular basis if required as they have no known side effects, and they are not known to be detrimental to the body’s tissues in any way. Because of its level of safety, hyaluronic acid is classed as a ‘medical device’ rather than a drug.

For optimal effect, chronically swollen joints can be treated first with steroids to reduce inflammation and then with hyaluronic acid around 4 weeks later, reducing the need for repeated steroid shots. Complete physio clinical specialist physiotherapists have worked with hyaluronic acid shots for many years and are thus able to give professional advice as to the usefulness of any patient presentation.


1. What is diagnostic musculoskeletal ultrasound?

An ultrasound probe emits high-frequency sound waves (echoes), which are reflected to the probe by the body’s tissues to form a live real-time image. Ultrasound is safe for children and adults and has no radiation. The quality of diagnostic ultrasound images is now considered to be superior to MRI scans for examination of certain tendons, ligaments, and muscle injuries.

2. Can a diagnostic ultrasound be performed at my appointment?

Yes, providing the clinical details correlate with suspected musculoskeletal injury. Neil Liffen has completed an MSc in musculoskeletal diagnostic ultrasound and has worked regularly in NHS radiology departments for more than 15 years. In a private clinic, Neil uses a state-of-the-art diagnostic ultrasound machine to diagnose and guide treatment.

3. What are the advantages of combining physical examination with diagnostic musculoskeletal ultrasound?

Physical examination and the use of specific tests can lack alone specificity and reliability. A cluster of specific tests may form a list of differential diagnoses. Diagnostic ultrasound can then be performed to confirm the diagnosis and correlate the findings with the physical examination.

4. Why is the cost of diagnostic ultrasound so cheap when compared to other private settings?

Simply, we do not have the overheads of other private settings and pride our clinics on value for money.

Just to let you know, a diagnosis is never made based on imaging alone, and any diagnostic ultrasound findings need to be clinically relevant to your symptoms/injury and combined with your history and physical examination. All findings will be discussed in the clinic. There may be an extra charge if a formal report is required.

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