Biochemistry of Local Anesthetics and Steroids Used for Selective Injections
Percutaneous selective injections including selective joint and soft-tissue injections as well as selective nerve root blocks are commonly performed by radiologists. Percutaneous selective injections are considered standard techniques in the diagnosis and treatment of various pain sources originating from the musculoskeletal system. Selective injections may be of great help in identifying the pain generator and can provide pain relief, which may maximize treatment and improve functional outcome. The rationale of these procedures is to deliver local anesthetics and/or steroids precisely within the joint cavity or to the immediate vicinity of either the nerve or the inflamed tissue. For this purpose, a needle is placed next to the presumed affected tissue target. Needle guidance may be achieved by fluoroscopy, computed tomography, or magnetic resonance imaging.