Sonoscope, Ware, Hertfordshire
Ultrasound guided steroid injection: right drug, right place
Rob Mast examines you, scans the painful structure and, when clinically appropriate, injects it in the same visit at Sonoscope in Ware. The steroid goes into the structure the scan has just confirmed, placed under live imaging.
You do not need a GP referral to ask.
Registered withHCPC PH47036
Ask before you book
Not sure a steroid is the right step?A reply within working hours, no obligation to book.
HCPC registered physiotherapist PH47036.
A guided steroid injection calms one inflamed structure
Sonoscope gives ultrasound guided steroid injections for joint, tendon and bursa pain across Hertfordshire, from the clinic in Ware.
Rob Mast examines you, scans the structure and places the injection under live imaging in one visit, for an all-inclusive fee from £250.
All-inclusive, in one visit.Consultation, examination, diagnostic scan and injection are all covered by the fee.
When a guided injection is the right answer for your pain
A steroid injection does its job when inflammation is causing the pain. That means a swollen bursa, an irritated tendon sheath, an inflamed joint lining or a tight capsule. The steroid switches off the inflammation in that one place, which takes the pain down and gives you room to move. It is often used to create a window for rehabilitation, so the weeks of relief are the weeks to get the joint strong.
For a worn joint it settles the inflamed lining, which is where most of the pain comes from, and Rob will tell you plainly how long that is likely to hold. The scan tells the difference. Rob looks at the structure on screen first, and an injection is given only when clinically appropriate, after examination and scan. If the scan shows a tendon that should be left alone, he will say so and explain what he would do instead.
Joints, tendons and bursae from the shoulder to the foot, in adults aged 17 and over.
Spinal injections and nerve blocks, which are done in hospital under X-ray guidance.
Where a steroid is the wrong tool, Rob may suggest hyaluronic acid to lubricate a joint or hydrodistension to stretch a frozen shoulder capsule.
£250 covers the examination, scan and guided steroid injection
An ultrasound guided steroid injection at Sonoscope costs £250, and that fee includes the consultation, the physical examination, the diagnostic scan and the injection itself.
- No GP referral
- No X-ray first
- No MRI first
The scan on the day is the imaging.
Published fees for the same treatment, taken from their price lists in September 2026. Bars are drawn to a £680 scale.
One fee, one visit, and you know the number before you book.
Fees for every other injection Rob offers are on the treatment costs page.
- The consultation with Rob Mast
- The physical examination
- The diagnostic ultrasound scan
- The guided steroid injection itself
The price you are quoted is the price you pay, with no hidden extras.
Book your assessment(opens in a new tab)No injection unless the examination and scan support it.
Three to seven days for the steroid to take hold
Depo-Medrone, the steroid Rob uses, usually starts to work three to seven days after the injection.
Here is the first week in order. Open any stage for the detail.
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First few hours Numb, and often much better
The local anaesthetic mixed with the steroid numbs the area, so many people walk out feeling much better.
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The first evening A dip on the first night is expected
That numbness fades, so a dip on the first night is expected. It is the anaesthetic wearing off, not the injection failing.
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Days three to seven The steroid takes hold
The steroid catches up over the following days and starts to take hold.
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End of the first week Most people notice the difference
Most people notice the difference by this point.
is where NICE, the body that sets NHS treatment guidance, puts the short-term benefit of a corticosteroid injection in osteoarthritis.
where a bursa or a tendon sheath was the cause, because that inflammation can settle for good.
Rob will tell you what is realistic for your structure, and there is a fuller answer on why some injections last months and others weeks.
Examination, scan and guided injection in one visit
Your appointment has five parts, and the injection is the shortest of them.
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Examination
Rob takes your history and examines the joint or tendon, so the scan is looking for something specific.
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Diagnostic scan
He scans the structure with high resolution ultrasound and shows you what he sees. This is the imaging, so no separate X-ray or MRI is needed.
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Decision
Rob confirms whether a steroid injection is the right step. Sometimes it is not, and you leave with a diagnosis and a plan instead.
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Guided injection
The skin is cleaned, and the steroid injection under ultrasound goes in while Rob watches the needle on screen. Most patients find it well tolerated.
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Aftercare advice
You get clear instructions on rest, loading and what to watch for, including getting home after your injection, as the area can stay numb for a few hours.
Guided steroid injections matched to each joint, shoulder to ankle
Ultrasound lets Rob see the exact structure, so the injection goes where the scan shows the problem and the dose is matched to the size of what is being injected.
Select an area on the body
Shoulder
A steroid injection for rotator cuff pain usually goes into the subacromial bursa, the cushion that sits over the tendons, because that is where the inflammation lives. Scanning first shows whether the bursa is thickened or a tendon is torn, which changes the plan. Rob also treats a painful bursa in the shoulder and frozen shoulder, where an injection into the capsule is offered at the earliest stage.
Shoulder conditions we treat
- Frozen shoulder
- Rotator cuff impingement
- Rotator cuff tears
- Shoulder bursitis (subacromial)
- Shoulder osteoarthritis
- Glenohumeral and AC joint pain (the shoulder joint and the joint at the top of the collarbone)
- Shoulder instability
Elbow
Elbow conditions we treat
- Tennis elbow
- Golfer's elbow
- Elbow osteoarthritis
- Biceps and triceps tendon pain
- Olecranon bursitis
Hand and wrist
A steroid injection for de Quervain's tenosynovitis goes into the tendon sheath on the thumb side of the wrist. It works: one comparison(opens in a new tab) found a guided injection matched surgery for pain and function at six months. Trigger finger and pressure on the median nerve at the wrist are treated the same way, with the needle placed beside the nerve or tendon under live imaging. Small structures get small doses.
Hand and wrist conditions we treat
- Carpal tunnel syndrome
- Trigger finger
- De Quervain's tenosynovitis
- Thumb base osteoarthritis (first CMC joint)
- Finger joint osteoarthritis
- Wrist osteoarthritis
Hip
A steroid injection into the hip joint sits deep, next to a large artery and nerve, so ultrasound is the safe way to place it. Pain on the outside of the hip usually comes from the trochanteric bursa or the gluteal tendons, and the scan shows which, so the injection goes into the right one.
Hip conditions we treat
- Hip osteoarthritis and hip joint pain
- Trochanteric bursitis
- Gluteal tendinopathy (gluteal tendon pain)
- Iliopsoas tendinopathy and bursitis
- Proximal hamstring tendinopathy (hamstring tendon pain at the sitting bone)
Knee
Knee steroid injections calm a flare of inflammation in the joint lining, and a guided needle reaches the joint space first time. For a knee with more advanced wear, Rob may also talk you through hyaluronic acid or Arthrosamid, so you leave knowing every option.
Knee conditions we treat
- Knee osteoarthritis
- Patellofemoral pain
- Patellar tendinopathy
- Iliotibial band (ITB) friction syndrome
- Baker's cyst
- Pre-patellar and infra-patellar bursitis (the bursae in front of and below the kneecap)
Foot and ankle
A steroid injection into the ankle joint, or the tendon sheaths beside it, is placed under ultrasound because the joint space is small. Rob also treats plantar fasciitis at the heel. Achilles pain gets a different injection, because a tendon that carries your weight needs a different approach from a steroid.
Foot and ankle conditions we treat
- Achilles tendinopathy
- Plantar fasciitis
- Morton's neuroma
- Ankle osteoarthritis
- Retrocalcaneal bursitis (the bursa behind the heel)
Some conditions listed here are treated with other injections, not a steroid. Rob chooses which one after the scan. See every condition we treat, or read how ultrasound guided injections work.
Will the injection hurt, and what else might I feel?
Most patients find it well tolerated, and many describe it as virtually painless.
The headlines below cover everything else. Open any one of them for the detail.
Patient comfort during the injection
Oo et al. (2024) (opens in a new tab) found that the use of real-time imaging also reduces pain during the injection procedure itself. Their systematic review investigating injections for knee, hip, and hand osteoarthritis found that ultrasound guidance demonstrated a large effect size in minimising pain during the injection procedure compared to landmark guidance.
Effectiveness
Huang et al. (2015) (opens in a new tab) showed in their meta-analysis of randomised controlled trials that ultrasound-guided intra-articular and peri-articular injections resulted in a significant decrease in Visual Analogue Scale (VAS) pain scores for up to six weeks post-injection compared to blind injections.
References
- Huang, Z., Du, S., Qi, Y., Chen, G. and Yan, W., 2015. Effectiveness of ultrasound guidance on intraarticular and periarticular joint injections: systematic review and meta-analysis of randomized trials. American Journal of Physical Medicine & Rehabilitation, 94(10), pp.775-783.
- Oo, W.M., Linklater, J., Siddiq, M.A.B., Fu, K. and Hunter, D.J., 2024. Comparison of ultrasound guidance with landmark guidance for symptomatic benefits in knee, hip and hand osteoarthritis: Systematic review and meta-analysis of randomised controlled trials. Australasian Journal of Ultrasound in Medicine, 27(2), pp.97-105.
Around one in ten get a flare for 24 to 48 hours
Around 10% of patients get a flare, a temporary rise in pain, for 24 to 48 hours. A flare is more likely when steroid lands outside the target and irritates tissue nearby, which is one reason guided injections produce fewer of them.
Other effects some people notice
- A flushed face for a few days.
- If you have diabetes, your blood sugar can run higher for up to a week, so check it more often.
- Occasionally the skin over the site lightens or a small dimple forms, more often in pigmented skin. This is cosmetic and usually fades.
Infection is rare with a clean technique
Serious problems are rare. Infection runs at around 1 in 10,000 with a clean technique, and the signs are easy to spot. They are set out in the band below this list, because they are the one thing worth acting on quickly.
Repeat injections into the same tendon are limited
Rob limits repeat injections into the same tendon, because too many in one place can weaken it, and follows how far apart repeat injections should be spaced.
An area that turns hot, swollen and more painful over the following days, or a feverish feeling. The signs of infection are easy to spot, and they need to be seen quickly.
Rob Mast chooses the steroid and the dose himself
Rob Mast is an independent prescriber, a status held by around 4% of UK physiotherapists. It means he decides which steroid to use and how much, based on what his scan shows, with no set protocol sheet and no doctor needed to sign it off. He never uses more than 40 mg of Depo-Medrone in one injection, and a small tendon sheath gets a fraction of that.
- Role
- Advanced Practice Physiotherapist and Musculoskeletal Sonographer
- Health and Care Professions Council
- PH47036
- Chartered Society of Physiotherapy
- 054814
- Qualification
- CASE-accredited postgraduate certificate in musculoskeletal ultrasound
Alongside Sonoscope he works as an interventional sonographer in an NHS hospital radiology department and teaches guided injection technique at Brunel University. After more than 20 years in musculoskeletal care, the scan is where his decisions start, and every injection here is placed under live imaging for the same reason.
Rob Mast at the Dolphin Medical and Therapy Rooms in Ware, Hertfordshire.
is the most Depo-Medrone Rob will use in one injection, and a small tendon sheath gets a fraction of that.
Before you book
Check these five answers before booking a guided injection
Clear answers on what cortisone is, what goes in the syringe, referrals, and what happens if the scan says an injection is the wrong step.
Is a cortisone injection a steroid?
Yes. A cortisone injection is a corticosteroid, a medicine that copies a hormone your body already makes to control inflammation. It is a different family from the anabolic steroids used for muscle building, and a guided cortisone injection into one structure has none of those effects. Cortisone and steroid are two names for the same injection at Sonoscope.
What is in the injection?
Two things: Depo-Medrone, a long-acting steroid, and a local anaesthetic. The anaesthetic numbs the area for a few hours and the steroid works over the following weeks. Rob combines them in one syringe, so there is a single injection.
Do I need a GP referral?
No. You can book with Sonoscope directly, and the examination and scan on the day replace the referral letter and the separate imaging. If you have private medical insurance, check with your insurer first, as some ask for a referral before they will pay.
What if the scan shows an injection is the wrong step?
Then Rob will tell you, and you leave with a diagnosis and a plan for what to do instead. That could be a different injection, a course of rehabilitation or an onward referral. He gives an injection only when the examination and the scan support it.
Can I have the injection at my first visit?
Yes, when clinically appropriate, after examination and scan. Assessment, scan and injection happen in one visit at the clinic in Ware, Hertfordshire, so there is no second appointment and no wait for a scan report.
Before you decide
One injection is a test as well as a treatment
How much it helps, and for how long, tells Rob which structure is driving your pain and what the right next step is.
That is why the scan comes first, and why the weeks after the injection matter as much as the needle.
If you are still weighing it up, ask before you book.