Ultrasound Guided Hip Injections

The hip joint is a ball and socket joint and is the largest weight-bearing joint in the human body. The head of the thighbone or femur forms the “ball” and the acetabulum of the pelvis is the “socket”.  These bones come together to form the hip joint.

The hip joint is made up of:

• Bones and joints
• Ligaments
• Muscles and tendons
• Nerves and blood vessels

The hip joint may become painful and inflamed due to various conditions.

Hip joint injections can help diagnose the source of pain as well as alleviate the discomfort. A hip joint injection is a mixture of an anaesthetic which blocks pain impulses and a steroid which reduces inflammation to the area. Hip joint injections are a conservative treatment approach to relieve hip pain.

Disease Overview

The hip joint helps to bear your body’s weight while standing, walking and running.  The joint may become painful and inflamed due to overuse, trauma or certain medical conditions such as osteoarthritis leading to pain in the hip, low back, buttock or leg. The pain may increase with certain activities and movements.

Indications

Hip joint injections are usually indicated to treat hip joint pain not relieved by other conservative treatment options. Conditions treated with hip joint injections include:

• Arthritis (inflammation of the joints)
• Bursitis (inflammation of the fluid-filled sacs that act as a cushion between bones and soft tissue present in the joint) 
• Synovitis (inflammation of the joint lining)
• Defects of the hip labrum (the raised rim of cartilage that borders the lining of the acetabulum)
• Trauma or post-surgical pain

Procedure

Hip joint injections are usually performed by a radiologist. You are requested to bring any previous scans or X-rays of your hip.

• For the procedure, you will lie on your back and with the help of an ultrasound scan, the injection site is identified and marked on your hip.
• The site is then cleansed and anesthetised.
• A needle is inserted through the site and guided into the hip joint with the help of live ultrasound imaging.
• An injection of anaesthetic and steroid medicine is then administered.
• Once completed, the needle is removed, and the injection site covered with a small dressing.
• The entire procedure takes approximately 15 to 30 minutes.
• You are observed for a while and if stable may return home.

Post-Procedural Care

Your doctor will prescribe medication and ice pack applications to help relieve any pain and soreness at the injection site.

You are advised not to drive, bathe or shower immediately after the procedure. The anaesthetic in the injection usually has an immediate effect. The steroid component will start to show effects in 2-3 days.

Risks and complications

Risks and complications with this procedure are rare and include

• Bruising at the injection site
• Allergic reaction
• Infection
• Leg problems or weakness

Summary

Ultrasound guided hip injections provide an effective treatment for hip pain and inflammation when medications and other conservative treatments are inadequate and surgery is not recommended. You may resume normal activities the day after the procedure as advised by your doctor. The procedure is minimally invasive, does not involve radiation, and may be repeated up to 3 times a year.