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The Royal Australian and New Zealand College of Radiologists®

Bursal Injection

Dr Iain Duncan
Dr Wes Cormick
Date last modified: May 14, 2013

1. What is a bursal injection?







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3. How do I prepare for a bursal injection?

No specific preparation is needed. You should take any previous X-rays, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) scans to the appointment.

When you make your appointment for the bursal injection, you need to let the radiology facility know if you are taking any blood thinning medication, particularly warfarin.



Continue with pain medication and other medications as usual.

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4. What happens during a bursal injection?

You will most likely be asked to change into a gown. This will depend on the area that is being injected. You will lie on a scanning bed or sit in a chair in a comfortable position, usually in an ultrasound room. A radiologist (specialist doctor) and/or the sonographer (ultrasound technician) will explain the procedure to you. You will be able to ask any questions.

The area to be injected is imaged to locate the bursa. Sometimes a mark is placed on the skin by the doctor to help guide the needle into the correct place. The skin is then cleaned with antiseptic liquid. A fine needle is passed directly into the bursa using ultrasound images to guide the placement of the needle. Occasionally, the needle is inserted at the point of maximum tenderness for a lateral hip injection, without using ultrasound guidance. A small amount of corticosteroid and local anaesthetic (usually just a few millilitres) is injected and the needle is removed. The needle is generally in and out again within a minute. Most people are surprised by how quick the procedure is.

The doctor will then give you instructions for after the injection. This will generally include completely resting the limb or the part of the body injected for 6 hours, and then limiting its use for between 1 and 3 days, sometimes longer.

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5. Are there any after effects of a bursal injection?


The corticosteroid does not usually start working for 24 hours, and sometimes this takes up to 3 days. During this time, the normal symptoms might continue or occasionally worsen. If symptoms are much worse, it generally indicates a reaction to part of the injected medication or to the injection itself. If you find this worrying or distressing, you should see your own doctor or contact the radiology facility where the procedure was carried out.


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6. How long does a bursal injection take?

The procedure itself rarely takes more than 5 minutes, and with the preparation (scanning, marking, explaining the procedure etc.) it will take approximately 15 minutes. If your own doctor has requested an ultrasound to assess the area as well as an injection, this can take up to 30 minutes.

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7. What are the risks of a bursal injection?

This is a very safe procedure with few significant risks. Few people complain of side-effects, but occasionally problems are experienced.

  1. The commonest complaint is a temporary worsening of the symptoms over 1, 2 or even 3 days.
  3. There is a very small risk of infection, which is minimised by the doctor carrying out the procedure in clean conditions. The injection will not be carried out if there is broken skin or infection in the skin over the bursal area, or if the bursa might already be infected. If symptoms do not settle or get worse, particularly if you feel unwell or have a temperature, you should see your own doctor.

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8. What are the benefits of a bursal injection?



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9. Who does the bursal injection?

The bursal injection is carried out by a radiologist (specialist doctor). A sonographer (ultrasound technician) will in general carry out the ultrasound and assist the doctor. The doctor will provide a written report, which is sent to your own doctor, detailing the results of the scan and the procedure.

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10. Where is a bursal injection done?

A bursal injection is usually carried out in either a hospital imaging department or a private radiology or nuclear medicine practice.

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11. When can I expect the results of my bursal injection?


  • the urgency with which the result is needed;
  • the complexity of the examination;



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12. Further information about bursal injection

The relief of symptoms from the bursal injection might last a few weeks to several months. It is therefore only part of an overall plan for managing your symptoms.  You would most likely have been advised to rest the affected area and also change the way you carry out some of your activities. You might have been taking anti-inflammatory tablets and having physical therapy to help the symptoms settle.

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13. Useful websites about bursal injection: