Ultrasound imaging accurately diagnoses and precisely guides the delivery of treatment to the painful joint. Too often people think of osteoarthritis as a cartilage disease, when in fact many steuctures that may be contributing to the pain may be outside the joint itself. For example in the knee, many patients have pain on the inside, inner or medial knee and tenderness below the jount. This is where tendons, a ligament, nerve and bursa may be causing the pain. Likewise on the outside or lateral knee pain and tenderness where a ligament and band, named the iliotibial band can actually cause pain to the side of the knee and thigh. Ultrasound imaging accurately visualizes these structures and needs to be included in the treatment to ensure accurate delivery and the best outcomes.