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Injections

Hyaluronic acid injection (large joint)

What is it?

[Sinovial® HL] [Sinogel®]

Advanced, ultrasound-guided treatment designed to improve joint function, reduce pain, and support longer-term recovery.


An ultrasound-guided injection delivers hyaluronic acid directly into a joint to help improve lubrication, reduce pain, and support joint function.


Hyaluronic acid is a naturally occurring component of synovial fluid. In conditions such as osteoarthritis, its concentration and quality can be reduced. Injection can help restore lubrication within the joint and improve movement.


We use advanced hyaluronic acid preparations from the Sinovial® HL range (IBSA), which combine high and low molecular weight hyaluronic acid. This hybrid structure is designed to improve joint lubrication, reduce inflammation, and support function.


Using ultrasound allows the clinician to visualise the joint in real time and guide the needle accurately into the correct area. This improves precision and ensures accurate delivery of the treatment.


Unlike corticosteroid injections, which primarily reduce inflammation, hyaluronic acid injections aim to improve the mechanical environment within the joint and may provide longer-lasting symptom relief in selected patients.

£420

Price

Who is it for?

This treatment may be suitable for adults with:


  • Osteoarthritis

  • Joint stiffness and reduced mobility

  • Degenerative joint conditions

  • Persistent joint pain not responding to physiotherapy or simple pain relief


It may be particularly helpful for:


  • Individuals with joint pain affecting daily activity

  • Patients seeking longer-lasting symptom relief

  • Those wishing to reduce reliance on repeated steroid injections

  • Active individuals aiming to maintain mobility and joint function

What will it assess?

Who performs it?

Procedures are performed by a specialist musculoskeletal (MSK) Consultant Radiologist with extensive experience in musculoskeletal imaging and ultrasound-guided interventions.

All procedures are performed under real-time ultrasound guidance to maximise accuracy and safety.

A chaperone will be present throughout the appointment.

Our team → 

How do I prepare?

Please wear loose, comfortable clothing that allows easy access to the area being treated.

Before your appointment, it is important to let us know if you:


  • Take blood-thinning medication

  • Have diabetes

  • Are pregnant or may be pregnant

  • Have any allergies

  • Have a current or recent infection

  • Have previously had an injection in the same area


You may be advised to avoid strenuous activity for a short period after the injection.

Will I need a referral?

This service is offered on a referral-only basis. A referral from an appropriately qualified healthcare professional is required prior to booking to ensure that treatment is appropriate and forms part of a safe, structured management plan.


Referrals are accepted from a range of healthcare professionals, including physiotherapists, general practitioners (GPs), and consultant doctors.


We work closely with Physio Space, an independent physiotherapy clinic based within the same building as Cardiff Ultrasound Clinic.


If you do not already have a referral, you can book a physiotherapy assessment with Physio Space. If treatment is clinically indicated, they can refer you directly and arrange follow-up and rehabilitation as needed.

Common injection areas

Ultrasound-guided hyaluronic acid injections can be performed in a range of joints, depending on the underlying condition.


Smaller joints typically require a lower volume of treatment, whereas larger joints such as the knee, hip and shoulder require a higher dose.


Commonly treated areas include:


Small joints:


  • Ankle and foot

  • Wrist and hand


Large joints:


  • Knee

  • Hip

  • Shoulder


If the area you require is not listed, please get in touch — we will be happy to advise whether treatment is appropriate.

What to expect after the injection

  • The procedure typically takes around 20–30 minutes in total

  • Mild discomfort or swelling at the injection site is common for a few days

  • Pain relief is usually gradual and may take several days to a few weeks to develop

  • Improvement in joint function and mobility often continues over time

  • Benefits may last for several months in appropriate cases

  • You may be advised to reduce strenuous activity for a short period

  • You will be asked to remain in the clinic for approximately 20–30 minutes after the injection to ensure you feel well before leaving.

  • You should not drive immediately after the injection


Seek medical advice if you develop increasing redness, swelling, warmth, or worsening pain after the injection.


Many patients experience improved joint movement and a reduction in pain, supporting return to normal activity and rehabilitation.

Important Information

Hyaluronic acid injections can provide symptom relief for many patients, particularly in osteoarthritis, although response varies between individuals.

Relief is not always immediate and may develop over several days to weeks following treatment.


As with any injection, there are small risks, including:


  • Temporary increase in pain after the injection

  • Bleeding

  • Infection


These risks will be discussed with you before treatment, and you will be asked to sign a written consent form.


If you have any questions, please get in touch — our team will be happy to help.



Advanced treatment option


An advanced hyaluronic acid treatment (Sinogel®) is available in selected cases.

This may be recommended where:

  • Symptoms persist despite previous treatment

  • A higher-grade formulation is clinically appropriate

Why choose us

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What will I receive?

  • A specialist ultrasound assessment of the affected area


  • An ultrasound-guided hyaluronic acid injection [Sinovial® HL] or [Sinogel®]


  • A clear explanation of the findings and treatment provided


  • Aftercare advice, including what to expect following the injection


  • A detailed digital medical report, including high-quality diagnostic images available within 24 hours


  • Secure online access to your report and images


  • Option to share your report electronically with your GP, physiotherapist, or referrer

Price

£420

Book an appointment

Tell us your symptoms or concern, and we’ll guide you to the right appointment.

We’re happy to discuss your health or concern, and assess which type of scan you need.

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