A well-detailed referral helps our radiologists plan the right approach the first time — reducing back-and-forth, avoiding delays, and getting your patient booked and treated sooner. Before you send a referral for an image-guided procedure, it's worth checking the following.

Specific anatomy

Name the exact joint or spinal level rather than a general region — "L4/5 right nerve root," not simply "lumbar spine." For joints, always specify laterality. Precise localisation lets us target the right structure and confirm the plan against imaging.

Anticoagulants and antiplatelets

List all agents and doses individually — please avoid "on blood thinners." Specific medication details are essential for assessing bleeding risk and planning safely around the procedure.

Allergies

Note any known contrast media or local anaesthetic allergies. This directly informs how the procedure is prepared and performed.

Relevant comorbidities

Flag anything that affects safety or planning — diabetes, immunosuppression, active infection, coagulopathy, or a recent injection at the same site.

Clinical question

Tell us what you're hoping to achieve. "For pain relief" and "diagnostic" call for different approaches, and knowing your intent helps the radiologist tailor the procedure to your patient's needs.

Lumbar facet joint injection
Consider for axial back pain that worsens with extension and rotation and eases when the patient leans forward. Typically seen in older patients, with no radiculopathy. Where facet joints are the likely pain generator, a targeted injection can provide both diagnostic clarity and relief.

Lumbar nerve root sleeve injection
Suited to radicular leg pain from nerve root compression, presenting in a clear dermatomal distribution and confirmed at a single level on MRI. A precise, level-specific option when the source of pain is well localised.

Lumbar epidural corticosteroid injection
Appropriate for diffuse lumbar or leg pain associated with disc pathology, where radiation is non-dermatomal, multiple or unclear levels are involved, and broader coverage is needed. A useful option for patients who are unsuitable for surgery.

CT-guided steroid and local anaesthetic injection (Sacroiliac joint)
For sacroiliac joint pain, where focal pain is localised adjacent to the posterior superior iliac spine and may refer to the central buttock, groin or proximal lateral thigh.

Shoulder hydrodilatation
For frozen shoulder (adhesive capsulitis) - the progressive loss of both active and passive range of motion, pain at rest and at night, and the characteristic capsular pattern. Hydrodilatation helps stretch and release the joint capsule to restore movement.

Joint injection (corticosteroid ± local anaesthetic)
For osteoarthritis or inflammatory arthropathy of the shoulder, knee, or hip, where there is joint-line tenderness confirmed on imaging and conservative treatment has failed or proven insufficient.

Bursal injection
For subacromial or trochanteric bursitis, presenting as localised tenderness over the bursa with pain on specific movements and confirmed on ultrasound.

Viscosupplement injection (hyaluronic acid ± corticosteroid)
For mild-to-moderate osteoarthritis of the knee, hip or shoulder, where mechanical or degenerative joint pain persists, corticosteroid injections have provided only short-lived relief or are undesirable (e.g. in patients with diabetes), and the patient is seeking longer-lasting symptom relief while delaying surgery.

Ultrasound-guided tendon sheath corticosteroid injection
Painful tendon sheath inflammation with locking (trigger finger) or radial wrist pain and positive Finkelstein test (De Quervain's); conservative treatment unsuccessful.

Carpal tunnel ultrasound-guided injection
For carpal tunnel syndrome where conservative treatment has failed, there are positive Tinel or Phalen signs, the diagnosis is confirmed clinically or by nerve conduction studies, and surgery has been declined or deferred.

Piriformis muscle steroid and local anaesthetic injection
Piriformis muscle dysfunction or irritation causing pain in the buttock, hip or leg.

Ultrasound or CT-guided piriformis muscle injection (steroid and long-acting local anaesthetic)
For piriformis muscle pain, characterised by deep buttock pain that is reproduced by internal hip rotation and resisted external rotation, targeting the superficial and deep portions of the piriformis muscle.

Ultrasound-guided hamstring tendon injection (steroid and local anaesthetic)
For hamstring syndrome, where lower buttock or proximal thigh pain worsens with exercise and chronic scar tissue is suspected of compressing the sciatic nerve