Musculoskeletal impairments are reported by more than one out of every four Americans, and in 2008 an estimated 46 million, or one in five adults, reported arthritis.1 Local injections of therapeutic agents into articular structures can lead to rapid decreases in pain and inflammation without many of the serious side effects associated with systemic medications. However, as with any diagnostic or therapeutic procedure, success depends on the expertise of the clinician and the accuracy with which the medications are injected into the affected joint space. Ultrasound is an emerging imaging modality which affords dynamic, real-time, cost-effective and physician-controlled visualization of anatomic impairments. Recent data has demonstrated that the use of ultrasound imaging improves accuracy rates in joint injections.