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Ultrasound helps visualize the muscles, tendons, ligaments, bones, joints and soft tissue of the hip region.  Ultrasound uses nonionizing radiation hence deemed as safety equipment for any age group including pregnant women. 

Diagnostic Ultrasound around the HIP region is able to identify:

  • Early arthritis changes.
  • Muscle or tendon tears.
  • Joint effusion.
  • Bursitis
  • Extra-articular cysts.

What are the limitations of the diagnostic Ultrasound in the hip region?

Like any other joints in the body, ultrasound cannot penetrate the bones, joints of the hip, therefore Intraarticular problems cannot be visualized on an ultrasound scan. Internal structures of the joints require either an MRI or CT scan.

hcpc registered
hip pain treatment warwickshire

Musculoskeletal issues?

If you are experiencing painful joints, muscles, tendons or ligaments please get in touch for a diagnostic scan and or treatment

Hip Conditions that we can diagnose and treat at our clinics:

Hip joint arthritis

Hip joint arthritis is one of the most common joint arthritis in the UK. Ultrasound-guided steroid injection to the hip joint is carried out as a diagnostic injection to confirm or rule out the source of pain and therapeutic injection for symptomatic relief.

There are various types of injections used for Hip joint symptoms.

Steroid Injections:

Steroid injections are very successful in controlling the hip joint symptoms. If you respond to the steroids, you may experience pain relief from 2-3 months to 18months. This depends on the severity of the problem, lifestyle, and other factors.

There is a limit on how many steroid injections can be given to the hip joint In a year.

Viscosupplementation / hyaluronic acid injections / gel injections :

Hyaluronic acid injections are particularly injected for those who are too young to have an operation or needed repeated injections There is no limit on the number of hyaluronic acid injections given to the hip joint. These injections help to enhance joint lubrication and work as a shock absorber. Hence, controls the worsening of arthritis and delays the hip surgery/ joint replacement.

Platelet Rich Plasma (PRP) Injections :

Plasma injections promote the natural healing process of damaged tissue. Plasma injections contain different growth factors concentrated 6-10 in comparison to the whole blood of the same volume. Thus enhances the natural healing process of joint cartilage. Plasma injections are made from the patients own blood, hence there is no limit on how many injections can be given in a year. Usually, a course of 3 injections is recommended.

What happens in the OA hip?

  • Inflammation of the soft tissue around the joint.
  • Joint and cartilage Wear and tear.
  • This leads to extra bony growth, called spurs/osteophytes.


  • Groin pain.
  • Joint Stiffness, especially after a period of rest and in the morning.
  • Joint pain. Pain is worse with weight-bearing activities, such as walking, running, jogging, swimming, climbing, and daily weight-bearing activities.
  • Some times may experience referred pain into the knee joint.
  • Often difficult to cope with hobbies, such as gardening, tennis, bowling, cricket, golf, walking, and jogging.

Advantages of Ultrasound (US) Guided HIP joint injection:

  • Cost-effective.
  • The hip joint is injected accurately.
  • Easily performed in an outpatient clinic.
  • Unlike fluoroscopy, ultrasound has no radiation risk.
  • Metal implants: This does not interfere with ultrasound waves.
  • If present, joint effusion can be aspirated at the same time as a hip injection.

Other Indications for Ultrasound-Guided Hip joint injection :

  • Femoro-acetabular impingement.
  • Para labral cysts.
  • Iliopsoas Bursitis.

Trochanteric  Bursititis


There several types of burse around the hip joint region. Among these Trochanteric bursae is the most common and Ischial bursa is another relatively common bursa. These are diagnosed and treated in joint care clinics.

Trochanteric Bursitis: 

Bursa is a fluid-filled sac and works as a shock absorber and lubricant for the movement of the tendons and muscles adjacent to it. Inflamed bursa causes pain, swelling, and difficulty in walking and carrying out other weight-bearing activities.

Bursitis is an inflammation of the bursa.

The trochanteric bursa is located at the trouser pocket level. If you are experiencing the pain on the outside of the hip at the pocket level and unable to lie on your side, it concludes the possibility of  ‘Trochanteric bursitis’.

Symptoms of Trochanteric Bursitis:

  • Pain over outside of the hip, thigh, and back of the hip.
  • Unable to lie on the side for any length of period.
  • Pain is often worse with activities, such as climbing stairs, getting up from a chair, getting out of the car.
  • Pain is worse when you palpate on the outer side of the hip at a pocket level.

What causes the Trochanteric Bursitis?

  • Weak hip muscles.
  • After a hip replacement.
  • After a knee replacement.
  • Fall: on to the side of the hip or
  • Overuse: long-standing job, walking, climbing.
  • Deposition of the calcifications in the gluteal tendons.
  • Tight ITB/TFL/Hamstring /quadriceps and other lower limb muscles.
  • H/o Inflammatory arthritis : Ex: Rheumatoid, psoriasis arthritis, Gout.
  • Poor posture: leg length difference, scoliosis, arthritis of the hip, lumbar spine, SI joint.

How to prevent recurring trochanteric bursitis following an ultrasound-guided injection:

Though the prevention of the bursitis is not always easy, the following steps prevent worsening of bursal inflammation:

  • Strengthen hip muscles.
  • Stretches to the leg muscles.
  • Avoid repetitive activities that strain the hip.
  • Correct the leg length differences, if noted.
  • Loose weight – in the case of overweight.

Ischial Bursitis


There several types of burse around the hip joint region. Among these Trochanteric bursae is the most common and Ischial bursa is another relatively common bursa. These are diagnosed and treated in joint care clinics.

It is an inflammation of the bursa, which is located over the ischium, part of the pelvic bone. The common complaint is the worsening of pain with sitting, especially on a hard surface.

Symptoms of Ischial Bursitis:

  • Worsening of pain with hamstring stretches.
  • While Climbing stairs.
  • Squatting
  • Karate, Martial arts, kickboxing,
  • Prolonged sitting.

How to prevent recurring ischial bursitis following an Ultrasound-guided injection:

Though the prevention of the bursitis is not always easy, the following steps prevent worsening of bursal inflammation:

  • Strengthen hip muscles.
  • Loose weight – in the case of overweight.
  • Prevent over-stretching of the hamstrings.
  • Avoid prolonged sitting, especially on hard surfaces.
  • Avoid repetitive activities that strain hamstring muscles.

Our in house clinical consultation combined with Diagnostic Ultrasound can detect bursitis problems. Also, a diagnostic ultrasound scan helps to detect tendon quality, possible tears, fluid accumulation, calcific deposits, bony spurs or collection of blood in case of a fall/ trauma to the side of the hip.

Ultrasound also helps to guide the needle to the trochanteric or ischial bursa, to inject steroid, plasma or hyaluronic acid /viscosupplementation accurately.  Ultrasound-guided injections are particularly useful for deeper and small structures.

 Why do I need an Ultrasound-guided injection?

  • If you need repeated injections.
  • Avoids accidental injection into the tendons.
  • Accurate injection offers prolonged pain relief.
  • The trochanteric/ischial bursa is a deep, thin structure In between the tendons, often difficult to inject accurately without guidance.
  • When landmark guided injection is failed to treat the symptoms. Ex, No relief from a landmark guided injection.


How long does an ultrasound guided injection take?

This will vary dependant on the area and other factors, but an assessment, scan & ultrasound-guided injection will generally take around 60 minutes. Ultrasound guided injection alone is done in a few seconds. Injection alone is carried out in few seconds. 

Are ultrasound guided injections painful?

Discomfort from the needle insertion can be minimised by using the local anaesthesia using a very fine small needle. Ram is an experienced and carried out more than 30,000 Ultrasound guided injections sofar. He routinely treats complex patients and patients with needle phobia, through the technique he developed through his experience. 

What is an ultrasound guided cortisone / Steroid / Corticosteroid injection?

Cortisone injection is also known as Corticosteroid injection  or steroid injection. This is a strong anti-inflammatory medication is used for many of the inflammatory and arthritis conditions to control pain, swelling, stiffness and improve function. Corticosteroid injections are NOT the same used by body builders use. Corticosteroid injections do not cause weight gain.  To find out more please visit our ultrasound-guided steroid injections page from the 'Types of Guided injection' menu on the top.

Always, consider having the Steroid injections under ultrasound guidance for accuracy. 

What is an ultrasound guided hyaluronic acid (HA) injection?

HA injection is also known as Gel injection or Lubricant injection. This viscosupplementation injection is a natural component of synovial fluid. This tends to increase joint fluid viscosity and restores the joint lubrication. Hence, acts as a shock absorber to control the joint /tendon symptoms. Limits the further damage to the joint and delays or avoids the need for the surgery. Aslo, helps to enjoy your daily activities or your preferred hobbies. To find out more please visit our  GUIDED ULTRASOUND HYALURONIC ACID INJECTIONS page from the 'Types of Guided injection' menu on the top.

These injections are very popular, especially for knee joint pain. Any number of injections can be taken in a given period, due to minimal or no side effects from these injections. Usually a course of 3 Injections are preferred, though some may do well just with an injection per year 9 we have patients managing just with 1/year

What is an ultrasound guided PRP injection?

Platelet Rich Plasma (PRP) injections are rich in growth factors ( helps in repairing the cell and its growth)  and prepared from the patient's own blood. Separated growth factors from the patients blood is injected back into the affected area of the same patient. Due to PRP's  ability to heal and even regenerate injured or aging tendons, ligaments and joints, providing some patients with an alternative to surgery. PRP therapy may reduce the required healing time for the injuries ( especially for sports injuries and early Arthritis ); otherwise athletes/ sports professionals may require longer periods of rest from their sports related activities.  To read more please visit our Ultrasound Guided PRP page.

 Always, consider having the PRP injections under ultrasound guidance for accuracy. 

can i drive after an injection

You will not be able to drive immediately after the procedure. Bring someone with you Or use other form of transport to return home. This is mainly due to your driving licence policy, rather injection efficacy. Majority of the motor insurance policies will not allow you to drive for 3-5 hours after the injection with Local Anesthesia

What should i expect after an injection?

After the injection you may feel pain free for couple of hours due to Local anaesthesia. However, pain returns after 2 hours, you may even feel more painful for couple of days due to bruising pain. Usually, you should starts feeling better from third day onwards. Pain relief from the steroid injection may take 1 to 2 weeks. 


How to manage bruising pain?

Discomfort from the needle insertion can be minimised by using an ice pack ( wrapped in a towel, to minimise the risk of frostbite from a direct skin contact) to the area of treatment. 3-4 times a day and 10-15 minutes at each time 

Will i always feel 100% pain free?

We can accurately inject the treatment area. However, pain relief depends on several factors, such as severity of the problem, body response to the steroid injection, rest period following an injection,  rehabilitation and exposing to the risk factors. 

how many injections can i receive?

corticosteroid Injections: 3 or 4 per treatment area / year.

Hyaluronic Acid : no limit as long as you are benefiting.

Platelet Rich Plasma (PRP) a course of 3, you can repeat as you like. 

What conditions can be treated?

Arthritis, Tendinopathies, Ligament, Muscle and Nerve related problems. We also offer trigger point injections for persistent pain ( usually a course of 2-5 are effective).

How long the injection effect lasts?

It is hard to determine without an assessment. It may be possible to estimate after assessing the patient. Usually, lasts up to 3 months. There are many patients who benefited for more than a year to 2 years. 


"I came to see Ram at his clinic regarding an ongoing issue with a tennis ball elbow injury. After carrying out an ultra scan he was able to carry out steroid injection. Very thorough and professional in explaining the root cause of the problem. Was able to give me an injection straight away and provide me with strict guidelines to follow after treatment. First class service and would highly recommend to anyone that requires pain management control."

Tennis Elbow Injury - Robbie Mehan


"Ram came to my home to deliver the treatment which was much appreciated. He was able to see me straight away, no waiting. We were able to look closely at the joint on ultrasound before he injected (hip) and see how it was looking. The injection was relatively pain-free (sharp scratch as it is done under local anaesthetic) and over fairly quickly. I have had an improvement in my mobility in the joint although I am still awaiting the full effect. I hope it will help me until the NHS are able to operate. Ram was very kind, very courteous and has kept in touch to check on my progress. Having sought other quotes for the same procedure he was very reasonable also. I would recommend him to anyone who has had this type of injection recommended to them by their Doctor.  Thank you, Ram, it was much appreciated.."

Hip Pain Treatment - Alison Augustus


"Excellent treatment for trochanteric bursa.
Ram explained the procedure for the steroid injection given. He answered all of my mother's questions and provided her with the documentation for aftercare.
The procedure itself was painless and performed to her complete satisfaction. I would have no hesitation in recommending Joint Care Clinics"

Trochanteric Bursa - Lisa Mackie


"Our experience with Ram has been very positive and we would happily recommend his services to anyone. Ram is a very polite and friendly professional who took the time to explain his work before undertaking a guided steroid injection into my Mother’s knee joint. After experiencing months of pain in her knee, Mum had a GP administered steroid injection but derived no benefit. After Ram’s guided steroid injection Mum reports no pain whatsoever and it has improved her mobility considerably. Thanks, Ram"

Knee pain treatment - Julie Melck


"Great Service & highly recommend Joint Care Clinics:
My Mother-In-law has chronic knee & ankle pain. She was on painkillers every day, the pills caused a lot of heartburn & didn't help much with the pain. Ramakrishna Rachaputi suggested & explained in detail about the possible treatments. My Mother-In-law received an ultrasound-guided Injection on her knee & ankle. After that, she started feeling a lot better and no need to take pain killers every day.
All thanks to Joint Care Clinics"

Knee and ankle pain treatment - Vara Prasad Manda


"Having been in severe pain for several months in desperation I rang the Joint Care Clinic. Rami visited me at home the next day and was very thorough with his assessment. I had a ultrasound-guided injection into my hip. 10 days on and the pain has almost gone. I would recommend Rami
to anyone suffering pain in their joints."

Hip pain treatment - michael john cambridge


"Great service. I am a L4 sports massage therapist and corrective exercise specialist - and I am thoroughly impressed with the competency and knowledge of Rama. I would recommend his great service to anyone who suffer from musculoskeletal problems."

James Tang Fitness


"I recently had an Ostenil plus injection from Ram. He was very knowledgeable and put my mind at ease about the injection. He explained the procedure really well. He used an ultrasound to find the area that needed the injection. I would highly recommend him and I will definitely have another ostenil injection. I had an Injection one year earlier and it has really helped and would have no hesitation in having another one."

Shirley Atkinson


"Rami, was very clear in describing the procedure of what might or not occur during and afterwards. Rami also helped to make the appointment very relaxed. I personally had a very good experience and wouldn't hesitate to return"

Terry Powton


"After experiencing bad arthritic knee pain I made an appointment with Ram for PRP injections, he was amazing, he explained everything clearly to me and reassured me as I am needle phobic, I would not hesitate to recommend this gentleman to anyone. Fantastic man ."

Knee pain treatment - JAN HATT


"I was suffering significant hip pain and the NHS muscular-skeletal unit were unable to diagnose the problem even though I had multiple scans including MRI. They were, therefore, unable to provide any treatment other than physiotherapy which didn't really help. At the first appointment with Ram, he was able via an ultrasound scan to diagnose Bursitis and give me a steroid injection. After a week or two, the pain was just about gone and my quality of life was significantly improved. I would highly recommend Ram."

hIP pain treatment - Jim McAlpine


"I have suffered problems with my left knee for several years now and have seen my local GP, Physio. , etc. and had various x-rays and treatment plans prescribed. Sadly, none of these have really helped and my knee has become progressively worse. Rami was excellent - taking a full background history to the problem followed by an exhaustive Ultrasound examination; fascinating to see ‘inside’ your knee in real-time! It is early days yet (just over one week) but , already I can start to feel an easing of the pain and a gradual ‘freeing-up’ of the joint. Overall I am very happy with the service and look forward to continuing improvement…"

James Walling


"Exceptional Service & highly recommend Joint Care Clinics:
My mum has chronic knee & ankle pain. She was on painkillers everyday, the pills caused a lot of heartburn & didn't help much with the pain. Ramakrishna Rachaputi suggested & explained in detail about the possible treatments. My mum received an ultrasound guided Injection on her knee & ankle. After that she started feeling a lot better and no need to take pain killers everyday. She did enjoy her holiday in UK.
All thanks to Joint Care Clinics"



We cover a wide area throughout Warwickshire and surrounds, either by home visit or clinics in the following areas: Rugby,  Coventry, Warwick, Solihull, Aylesbury,  Milton Keynes,  Leamington Spa, Stratford, Kenilworth, Whitnash, Atherstone, Bedworth, Leicester and Nuneaton. We also have clinics throughout the West Midlands including Birmingham and Solihull. We also have a clinic in Newcastle covering the North East.

If you do not see your area listed please still get in touch as we may be able to refer you to another practitioner in your area.

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