Hip anesthetic arthrogram injection (fluoroscopic guided)

Case contributed by Dr Dai Roberts

Presentation

For image guided hyaluronic acid injection.

Patient Data

Age: 50 years
Gender: Female
Fluoroscopy

Injection of iodinated contrast

With a 22G Quincke needle in situ, injection of iodinated contrast shows extension into the superolateral and anterior aspects of the head neck portion of the hip joint. 

Fluoroscopy

Post administration of injectate

Post injection image with the needle removed, showing the hip joint distended with radiopaque contrast and non radiopaque hyaluronic acid.  Hyaluronic acid is a novel viscous agent starting to be used in those with osteoarthritis trying to delay having a joint replacement.  

Case Discussion

Hyaluronic acid is a novel viscous agent which is starting to be used in joint injections in those with early arthropathy.  Syringes come both combined with corticosteroid and in isolation, so an awareness of trade names and contents are important to check pre-procedure.   Hyaluronic acid is expensive so ensuring the needle is in a good intra-articular position with iodinated contrast before giving is necessary.  

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Case information

rID: 76490
Published: 29th Apr 2020
Last edited: 9th May 2020
Inclusion in quiz mode: Included
Institution: St. Paul's Hospital