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Ultrasound-guided hip joint injection is a joint injection in the hip, assisted by medical ultrasound. Hip and groin pain often presents a diagnostic and therapeutic challenge. The differential diagnosis is extensive, comprising intra-articular and extra-articular pathology and referred pain from lumbar spine, knee and elsewhere in the pelvis.
The needle size, length and type should be selected based on the site, depth and patient's body habitus. 22–24G needles are sufficed for most injections. [1] As an example, ultrasound-guided hip joint injection [16] can be considered when symptoms persist despite initial treatment options such as activity modification, analgesia and physical ...
For those whose pain doesn't improve with medication and rest, the deposit can be dissolved and removed with techniques called "ultrasound-guided needling", "barbotage", and "US-PICT" (for "ultrasound percutaneous injection in calcific tenditis"). In each, ultrasound is used to locate the deposit and guide a needle to the affected site.
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Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, blood vessels, and internal organs, to measure some characteristics (e.g., distances and velocities) or to generate an informative audible sound.
The needle is radiographically guided into the glenohumeral joint space, after which the patient is evaluated by fluoroscopy, CT or MRI. The gadolinium in the contrast fluid yields a bright signal on T1 weighted images allowing for better evaluation of the joint capsule, the articular surface of the bones and, in particular, the labral cartilage.
Modern portable ultrasound devices allow the user to visualize internal anatomy, including the nerves to be blocked, neighboring anatomic structures and the needle as it approaches the nerves. Observation of local anesthetic surrounding the nerves during ultrasound-guided injection is predictive of a successful block. [5]
Ultrasound scan (left) and ultrasound-guided injection (right) of the piriformis muscle. Gmax = gluteus maximus; Pm = piriformis muscle; sn = sciatic nerve; S = sacrum; H = hip bone. Injections are part of multi-modal therapy and can be therapeutic.