What do the images show?
The first image shows evidence of osteoarthritis in the weight-bearing aspect of the hip joint. The radiopaque metal marker is used to help guide the marking of the skin entry point. The image stack shows the injection of iodinated contrast and confirms an intra-articular needle position.
Would you use lidocaine before using the 22G needle to reach the joint?
Injecting lidocaine with a smaller gauge needle, i.e. 25G, before using the larger 22G needle can make the procedure more comfortable. However injecting lidocaine into the superficial soft tissues can be uncomfortable itself, so if used it should be injected slowly.
Marking an entry point & injection of contrast
The planning for and intra-articular injection of iodinated contrast into the right hip which confirms an intra-articular needle position.