Disclosures: Lyndly J. Tamura, MD: Nothing to disclose

Objective: Through the use of fluoroscopy, we will evaluate the accuracy of an ultrasound guided intra-articular hip injection via a novel posterior approach.

Design: Case series.

Setting: Outpatient Surgery Suite.

Participants: A goal of 10 subjects referred to PM&R Sports Medicine clinic with intra-articular hip pathology and in need of a therapeutic intra-articular hip injection. We have recruited 4 participants thus far.

Interventions: With the patient lying prone, we performed an intra-articular hip injection from a novel posterior approach under ultrasound guidance. The needle was guided longitudinally (to the transducer) towards the posterior hip capsule at the femoral head-neck junction. After the needle was properly positioned, Isovue was injected into the joint. Correct placement was confirmed by checking arthrogram via fluoroscopy. After confirmation, a mixture of analgesic and steroid was injected into the hip joint.

Main Outcome Measures: Accuracy of the intra-articular hip injection, number of attempts to correctly access the joint, pain scale before and after the injection, complications.

Results: Thus far, we have performed this intervention on 4 patients. Fluoroscopy confirmed that we were able to access the hip joint from a posterior approach on first attempt. No further needle adjustment was needed. All 4 participants had an improvement on the Numeric Pain Rating Scale by 1-5 points. No complications were encountered through this posterior approach.

Conclusions: We are able to accurately access the hip joint via a novel posterior approach under ultrasound. This particular approach could be useful in a subset of patients who may not be candidates for the traditional anterior approach (i.e. those with an inability to lie supine, hip flexion contracture, large body habitus, etc.).

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/accuracy-of-ultrasound-guided-intra-articular-hip-injections-via-a-novel-posterior-approach/