AIM: This article emphasizes the essential role of radiological imaging in high-pressure injection injury (HPII) management and assesses the results of Magnetic Resonance Imaging (MRI) examinations in providing better details about foreign material extension and assisting surgeons in visualizing operational movement during surgery. Additionally, it shares the authors' experience in managing 16 HPII patients and investigates the application of bone cement in the treatment of injection injuries. METHODS: Data collection of HPII patients was performed between January 2020 and June 2022 in our department, with 16 HPII patients hospitalized with mild to severe high injection injuries. We presented four cases in detail and briefly summarized all 16 cases. The previously reported HPII cases were also investigated to provide a better conclusion and comparison. RESULTS: MRI examinations can provide vital details about the extent of foreign material extension, helping surgeons achieve better outcomes. Four detailed cases and a summary of 16 cases are presented. The study also found that polyurethane materials were commonly injected with a low amputation rate, and bone cement application was beneficial in reducing inflammation and infection. CONCLUSIONS: The study highlights the importance of MRI in diagnosing HPII and the potential benefits of using bone cement to control infections and decrease the number of surgeries. The comprehensive approach described ensures better outcomes and reduces the rate of severe consequences like amputation.