Disclosures: Andy P. Boyer: No financial relationships or conflicts of interest

Background and/or Objectives: The main objective of this study was to identify if fluoroscopy or ultrasound more often obtains fluid from native and post-arthroplasty hip joints. The secondary goal was to identify potential factors associated with the ability to obtain fluid.

Design: A retrospective analysis of all hip aspirations performed at a single institution was undertaken, with the primary outcome variable being successful attainment of joint fluid.

Setting: A retrospective review of all hip joint aspirations was undertaken from a single academic institution. All were performed at an outpatient orthopedic clinic, with aspirations performed by physicians with fellowship training in musculoskeletal radiology, sports medicine, or pain medicine.

Participants: This study was approved by the primary institution’s internal review board as an exempt study given the retrospective, anonymous nature of the review. All included patients presented to clinic for hip joint aspiration procedures.

Interventions: Fluoroscopic-guided Aspirations, Ultrasound-guided Aspirations

Main Outcome Measures: The primary outcome variable was successful attainment of hip joint fluid (more than 0.1mL of joint fluid). Age, body mass index (BMI), sex, presence of a trainee, presence of an arthroplasty at the time of aspiration on the affected side, amount of fluid collected (if any), and type of image guidance were collected.

Results: Ultrasound guidance and lower BMI were associated with a significantly higher likelihood of obtaining fluid. The odds of obtaining fluid were approximately 2.1 times greater with ultrasound guidance than fluoroscopy guidance (95% CI = 1.382, 3.117; p < 0.001). Additionally, one unit decrease in BMI was associated with about a 3% increase in the odds of obtaining fluid (95% CI = 0.950, 0.998; p = 0.033).

Conclusions: This study supports the conclusion that ultrasound guidance for hip joint aspiration is more likely to successfully obtain fluid and obtain greater amounts of fluid. Given the other advantages of ultrasound, it may be the method of choice in hip joint aspirations.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/ultrasound-guidance-leads-to-greater-likelihood-of-obtaining-fluid-in-hip-aspirations-when-compared-with-fluoroscopic-guidance/