Musculoskeletal conditions are often managed conservatively, and injection therapies can serve as a diagnostic and therapeutic adjunct in their management. Corticosteroids are commonly injected into joints and soft tissues for their anti-inflammatory properties in pain reduction. Although these injections are widely used, their potential long-term risks, including chondrotoxicity, require careful evaluation of their role in short-term pain relief. Based on current research, hyaluronic acid and prolotherapy may offer pain relief with a potentially lower risk profile compared with corticosteroids, but they are not typically covered by health insurance. Platelet-rich plasma has shown mixed but generally promising results for multiple indications, although its use is limited by out-of-pocket expense. Stem cell therapy remains largely experimental. Compared with landmark-guided techniques, ultrasound guidance offers clinicians increased injection accuracy, safety, and the ability to perform injections that previously required specialty referral.

Case 2. AB is a 55-year-old woman with a history of osteoarthritis of the right knee who presents with increased pain and reduced mobility during the past 6 months. She has tried physical therapy and oral anti-inflammatory medications with limited relief and is asking about the potential benefits of corticosteroid injections.

Musculoskeletal conditions are reported by 48% of the US population and account for a substantial component of many primary care visits.¹ Joint and soft tissue conditions can be treated with injection therapy (Table 1¹).