When discomfort originates deep within the knee, shoulder, or other treated joints, precise targeting is essential for effective care. Fluoroscopy is a real-time X-ray imaging technology that helps providers visualize bones, joints, and needle placement with clarity, allowing medication to be delivered accurately where it is needed.
Medically reviewed by: Dr. Jeffrey Galvin & Ariel Curtis, FNP-C
Fluoroscopy is a type of medical imaging that uses continuous X-ray beams to create real-time, moving images of the body’s internal structures. Unlike a standard X-ray, which captures a single still image, fluoroscopy shows dynamic movement, allowing the physician to guide a needle precisely to the target while watching its progress on a monitor.
For interventional pain procedures, fluoroscopy is invaluable because it:
Ideal for accurately targeting treated joints such as the knee and shoulder when image-guided precision is needed.
Ensures medication is delivered to the intended target.
Avoids accidental injection into blood vessels or unintended spaces.
Increases the likelihood of therapeutic success.
At Joint Health Solutions, we use both fluoroscopy and ultrasound guidance, selecting the best modality for each patient and condition.
| Feature | Fluoroscopy | Ultrasound |
|---|---|---|
| Imaging Type | Real-time X-ray | Sound waves |
| Best For | Knee, Shoulder, joint, and deep bony structures. | Soft tissues, tendons, bursae, fluid, and superficial joints. |
| Advantages | Excellent bone visualization; confirms precise contrast spread. | No radiation exposure; visualizes soft tissue pathology in real-time. |
| Disadvantages | Small radiation exposure; limited soft-tissue detail. | Limited penetration for deep structures; highly operator dependent. |
For select knee and shoulder joint injections, fluoroscopy may be used to support accurate visualization and precise medication placement. Ultrasound may also be used when clinically appropriate for certain joint and soft-tissue concerns.
Fluoroscopy-guided knee injections help providers place medication accurately into the knee joint when added precision is needed.
Best for:
Reduced mobility caused by knee joint irritation
Fluoroscopy-guided shoulder injections may be used to support accurate medication placement for shoulder joint concerns.
Best for:
Limited range of motion
Cortisone injections may help reduce inflammation and support short-term comfort in treated joints.
Best for:
Temporary relief during active symptoms
Hyaluronic acid injections are commonly used for knee osteoarthritis to help improve joint cushioning and movement.
Best for:
Non-surgical osteoarthritis management
PRP therapy uses concentrated platelets from your own blood to support tissue repair and joint health.
Best for:
Tissue recovery support
Toradol is a non-opioid anti-inflammatory injection used for short-term relief during acute joint flare-ups.
Best for:
Patients needing temporary symptom support when clinically appropriate
We discuss all risks before the procedure and take every precaution to ensure safety.
| Procedure | Typical Duration |
|---|---|
| Cortisone Injection | Relief may last weeks to months, depending on the joint condition and patient response. |
| Hyaluronic Acid Injection | Results may last 6–12 months for many knee osteoarthritis patients. |
| PRP Therapy | Results may last 6–12+ months, depending on the patient’s condition, healing response, and care plan. |
| Toradol Injection | Short-term relief; used for acute flare-ups when clinically appropriate. |
Dr. Jeffrey Galvin and Ariel Curtis, FNP-C, have extensive training in interventional osteoarthritis management and regenerative medicine.
All injections are performed under ultrasound or fluoroscopy for accuracy and safety.
We offer a full spectrum of injection therapies, from traditional to regenerative.
Your treatment plan is tailored to your specific condition, goals, and lifestyle.
Serving patients from Charlotte, Huntersville, Concord, Matthews, and surrounding areas.
Fluoroscopy uses real-time X-ray to visualize bone and joint spaces, making it ideal for knee and shoulder. Ultrasound uses sound waves to visualize soft tissues such as tendons and bursae and is preferred for shoulder, knee, and superficial structures. Both are image-guided techniques that improve accuracy and safety.
Yes. When performed by trained specialists using sterile technique and low-dose radiation protocols, fluoroscopy-guided injections are very safe. Risks are rare and typically minor, such as temporary pain or bruising.
Fluoroscopy uses a low dose of radiation, typically equivalent to only a few chest X-rays. We use the ALARA principle—as low as reasonably achievable—to minimize exposure while maintaining image quality.
It depends on the type of blood thinner and the procedure’s risk profile. Some patients may need to temporarily hold medication with approval from their prescribing physician, while others may proceed with precautions. We review each case individually.
The procedure itself typically takes 10–20 minutes. Including preparation and post-procedure monitoring, plan to be in the office for about 45–60 minutes.
Most patients feel a brief sting from the local anesthetic and then pressure as the needle is advanced. The injection of medication may cause temporary discomfort or a sensation of fullness. Overall, the procedure is well tolerated.
Corticosteroids often begin working within 24–72 hours, though full effect may take up to a week. Diagnostic blocks may provide immediate relief within minutes if the anesthetic reaches the correct target.
It depends on the condition. Some patients need only one injection, while others may benefit from a series, such as an epidural series for radiculopathy. If a diagnostic block is positive, longer-lasting options such as radiofrequency ablation may be recommended.
Coverage for image-guided joint injections can vary by treatment type, insurance plan, and medical necessity. Our team will review your benefits before treatment and explain any expected out-of-pocket costs so you can make an informed decision.
You may be a candidate if you have spine-related pain such as neck pain, back pain, or sciatica that has not improved with conservative care; hip pain suspected from osteoarthritis or labral pathology; need diagnostic confirmation to guide further treatment; or are preparing for physical therapy and need pain relief to participate effectively.
If you are dealing with knee or shoulder joint discomfort, arthritis-related flare-ups, or limited mobility and want precise, image-guided care, schedule a consultation at Joint Health Solutions in Charlotte. Our team will help determine whether fluoroscopy-guided injections are appropriate for your needs.
