Landmark and Fluoroscopy Guidance

Landmark injection uses palpable surface anatomy to place a needle and suits many large, accessible targets; fluoroscopy uses real-time X-ray to reach deep or bony targets such as spinal facet joints.

Not every injection needs ultrasound. Some targets are better defined or more reliably confirmed with fluoroscopy or computed tomography (CT), so the sport and exercise medicine (SEM) clinician needs to know when a landmark technique is enough and when another form of guidance is needed.

Fluoroscopy brings the legal and practical duties of ionising radiation. These are set out in regulations that apply across Great Britain, with separate corresponding regulations in Northern Ireland.

This page covers:

• •When landmark technique is adequate
• •How fluoroscopy is used and regulated in the UK
• •How to choose between the forms of guidance