Effectiveness of Ultrasound Guided Intraarticular Injections with Lidocaine and Triamcinolone: A Retrospective Study of Primary Hip Injections.

Abstract

Background: Ultrasound guided hip injections have played a major role in the in-office diagnosis and treatment of a variety of traumatic and degenerative hip joint conditions. There is limited information as to the onset and duration of relief from these types of injections using a uniform medication combination.

Hypothesis/purpose: The purpose of the study is to evaluate the clinical characteristics of a population of patients undergoing ultrasound guided hip corticosteroid injections. We hypothesized that these injections have a low complication rate and a high degree of pain relief for patients.

Study design: Case Series.

Methods: We performed a retrospective study on 117 first time hip intraarticular injections performed by one operator using a single ultrasound machine and using the identical technique. In all cases, the hip joint was injected with 4 mL of 1% lidocaine and triamcinolone 40mg. The preinjection pain score was available in 98 hips with a mean of 6.4 ± 1.9 (mean ± S.D).

Results: 96% of patients had immediate improvement of pain (113/117). There were more right than left hips (67 vs 50) and more females than males (63 vs 54). The most common underlying diagnosis was osteoarthritis (53%). The relief duration was less than 3 months for most patients but longer than 6 months in 4 patients. Adverse outcomes were minimal with no infections and one allergic reaction.

Conclusion: This series represents the largest series of first time hip intraarticular injections with lidocaine and triamcinolone. This regimen has a high probability of immediate pain relief and low complications based on this series of patients.