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Intervention and Pain Management

What are interventional procedures?

Interventional pain management includes a range of specialised, minimally-invasive techniques for diagnostics and treating pain that are used by interventional radiologists. This usually consists of using a fine needle to deliver a treatment or take a sample from the target area. To ensure that the procedure is properly targeted, interventional procedures may be guided with the aid of a CT or Ultrasound scan.

What are interventional procedures used for?

Interventional procedures usually involve the injection of a target area in order to relieve pain and/or improve mobility.

These procedures can delay or help avoid more invasive procedures such as surgery.

Interventional procedures are also used to aid imaging diagnosis. An injection of contrast can help to better reveal abnormalities and confirm a diagnosis such as examining a joint (CT arthrogram).

A fine needle aspiration biopsy can be used to take a sample of cells which can provide information on the treatment options for a patient.

The types of procedures offered at Adelaide MRI include:

    • Lumbar spinal epidural steroid injection. These procedures involve the injection of steroids to the lower back in order to relieve pain and improve mobility. They are guided with a CT scan.
    • Cervical spinal nerve root steroid injections. These procedures involve the injection of steroids to the cervical spine (neck) in order to relieve pain and improve mobility. They are guided with a CT scan.
    • Thoracic spinal joint injections. These procedures involve the injection of steroids to the  thoracic spine (mid back) in order to relieve pain and improve mobility.They are guided with a CT scan.
    • Joint injections. These procedures involve the injection of steroids and anaesthetic into joints including the shoulder, wrist, hip, and knee in order to relieve pain and improve mobility. They are usually guided with an ultrasound scan.
    • Bursae ligament and tendon sheath injections. These treatments involve the injection of steroids to relieve the symptoms of bursitis and inflammation in bursae and tendons including the shoulder, wrist, hip, knee and ankle. They are guided using an ultrasound scan.
    • Carpal tunnel and ulnar nerve perineural injections (wrist). These procedures involve the injection of steroids and anaesthetic into the space around inflamed nerves. They are guided with an ultrasound scan.
    • Fine needle aspiration biopsy. In these procedures, a needle is used to obtain a sample of cells from a mass or organ. Fine needle aspiration biopsies can be taken from areas including the breast and thyroid. They are guided with an ultrasound or CT scan.

How do I prepare for interventional procedures?

You must ring and book an appointment to ensure you are correctly prepared. Please bring your doctor’s request form, your Medicare card and any previous latest INR (Interventional Neuroradiology) or APPT result. While preparation varies with the type of examination, most examinations do not require any preparation. Our friendly staff will advise you if any preparation is required. You are welcome to ask questions regarding your examination at any time.

Let our staff know if you are on blood-thinning medications or if you are being treated for a kidney problem or are a diabetic. Discuss the procedure with your referring doctor, as you may need to stop your warfarin or other blood-thinning medication prior to the procedure.

What happens during an interventional procedure?

You may have been referred for an ultrasound-guided interventional procedure, such as a steroid injection, contrast injection, biopsy, or aspiration. The sonographer will explain the procedure to you. The radiologist will perform the interventional procedure and answer any questions to ensure that you can provide fully-informed consent.

An interventional radiology procedure involves the placement of a fine needle through your skin and into a designated location. We often use local anaesthesia along with our injections, but you may decline the use of local anaesthesia. Following insertion, the needle will be guided into position, using either a CT scan or ultrasound.

The position of the needle may be confirmed by the injection of contrast material (“dye”) and/or removal of fluid. If contrast material is injected into one of your veins, you may be asked to hold your breath for several seconds as some pictures are taken. During the injection of the X-ray contrast material, you may experience a warm feeling or a strange taste in your mouth. These sensations are temporary and will go away soon.

It may be necessary to make more than one pass of the needle to achieve the proper location and/or to acquire sufficient material to complete the procedure.

Are interventional procedures safe?

Adelaide MRI always observes strict sterile procedures at our practices to maintain infection control. We often use local anaesthesia along with our injections, but you may decline the use of local anaesthesia.

Recognised complications include: pain or discomfort at the needle insertion site, bruising or infection after any needle puncture. Please consult your doctor if you notice any redness, heat, or pain at the injection / procedural site after the procedure. While risks are rare, various allergic reactions or a temporary reduction in kidney function are associated with contrast material (“dye”).

How much do interventional procedures cost?

Adelaide MRI is committed to ensuring its imaging services are affordable, which means that it bulk-bills allMedicare-eligible interventional procedures. Bulk billing means you have no gap payment and face no large unexpected out-of-pocket expenses. Please check if your scan is Medicare-eligible when booking. The Medicare schedule has very specific guidelines about which examinations are eligible.

It is your choice where to have your interventional procedures including scans and X-rays. Call us for an appointment with any referring doctor’s imaging request form.

Sometimes your doctor may require traditional large-format plastic images. If so, let us know and we will print plastic images for you – a small charge of $20 applies for these copies.

Fees apply where interventional procedures are not Medicare-eligible. Please ask our reception staff when booking.

What happens to my results?

Your results are treated with strict confidentiality. If a treatment has been administered immediately following a scan, details of the treatment and the patient’s reaction to it will be included in the written report sent to the GP. These reports are returned within 48 hours. This also applies in the case of contrast injections.

In the case of fine needle biopsies, we routinely arrange for a pathologist to be on site looking at the samples we obtain at the time of biopsy and we will need to arrange a time appropriate for you and the pathologist. Samples are processed in the pathology laboratory and results are sent to your doctor. This will take a few days. You will be required to sign a pathology form.