Disclosures: Anthony Kenrick, MD: No financial relationships or conflicts of interest

Objective: To describe and determine the accuracy of a new technique for performing ultrasound-guided needle placement for iliopsoas bursa injections after total hip arthroplasty as an alternative method to fluoroscopic guidance

Design: Retrospective consecutive case seriesSetting : Ambulatory surgery centerParticipants : Individuals with a history of total hip arthroplasty who were referred for iliopsoas tendon sheath corticosteroid injections for iliopsoas impingement syndrome and tendinopathy after June 2017

Interventions: Iliopsoas bursa corticosteroid injections were performed with sonographic guidance for needle placement, using a longitudinal approach relative to the iliopsoas muscle and tendon, guided by three sonographic landmarks of hip arthroplasty hardware. Needle placement was confirmed by fluoroscopic evaluation of contrast flow pattern.

Main Outcome Measures: Incidence of needle repositioning required after initial placement under ultrasound and confirmation with fluoroscopy

Results: Use of a longitudinal, in-plane approach relative to the iliopsoas muscle and tendon with sonographic landmarks of hip arthroplasty hardware is a reliable way to perform ultrasound-guided iliopsoas bursa injections, with accuracy comparable to traditional techniques described in native hips.Conclusions: In individuals with iliopsoas impingement syndrome after total hip arthroplasty, iliopsoas bursa injection can be done with ultrasound guidance without the need for fluoroscopic confirmation. This increases accessibility of the intervention and reduces potential risk of radiation exposure previously associated with the procedure.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/sonographically-guided-iliopsoas-bursa-injections-after-total-hip-arthroplasty-description-of-a-new-technique-and-validation-with-fluoroscopy/