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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 ...
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.
Ultrasound can ablate tumors or other tissue non-invasively. [4] This is accomplished using a technique known as high intensity focused ultrasound (HIFU), also called focused ultrasound surgery. This procedure uses generally lower frequencies than medical diagnostic ultrasound (250–2000 kHz), but significantly higher time-averaged intensities.
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.
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.
Single-injection techniques provide unreliable blockade in the areas supplied by the musculocutaneous and radial nerves. Current evidence suggests that a triple-stimulation technique — with injections on the musculocutaneous, median and radial nerves — is the best technique for the axillary block. [11]
These techniques are known as Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) [31] [32] and Ultrasound guided Focused Ultrasound Surgery (USgFUS) respectively. [ 1 ] [ 33 ] MRgFUS is a 3D imaging technique which features high soft tissue contrast and provides information about temperature, thus allowing to monitor ablation.