Hip arthrogram injection (fluoroscopic guided)

Case contributed by Dr Dai Roberts

Presentation

Discomfort in groin when exercising. For MRA.

Patient Data

Age: 40 years
Gender: Female
Fluoroscopy

Injection of iodinated contrast

The stack of images shows a 22G 90mm Quincke needle targeting the superolateral aspect of the femoral neck. Iodinated contrast extends to surround the femoral neck within the hip joint. 

Fluoroscopy

Post administration of injectate

Post-injection image after the needle has been removed which shows the expected appearance, with iodinated contrast filling the hip joint. 10mL of arthrogram injectate was given in total. 

Case Discussion

An 'eye of a needle' technique was used during this procedure. This involves inserting the needle in line with the x-ray beam and it will often appear as a dot if perfectly aligned or as it's shown in this case, the hub is slightly off-center from the tip.  Due to the projection, the needle appears short, despite being 90mm long.  

Different volumes of arthrogram injectate should be used in different joints, a total volume of 10mL was used for this MRI hip arthrogram injection.  

Further reading available in Arthrogram (MRI).  

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Case information

rID: 75553
Published: 1st Apr 2020
Last edited: 8th May 2020
Inclusion in quiz mode: Included
Institution: St. Paul's Hospital