J Korean Soc Radiol.  2013 Mar;68(3):237-243. 10.3348/jksr.2013.68.3.237.

The Effectiveness of Ultrasound-Guided Steroid Injection for Femoroacetabular Impingement: A Comparison between the Extra-Articular and Intra-Articular Approaches

Affiliations
  • 1Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 2Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, Korea. jaywony@gmail.com
  • 3Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

PURPOSE
To assess the effectiveness of pain control using ultrasound-guided steroid injection by the extra-articular and intra-articular approaches to femoroacetabular impingement patients.
MATERIALS AND METHODS
From September through December 2010, 18 patients with clinical suspicion of femoroacetabular impingement syndrome underwent ultrasound-guided steroid and local anesthetics injection: a total of 20 cases, including 16 cases of ipsilateral and 2 cases of bilateral injection. Extra-articular or intra-articular approach was selected for each patient, randomly and alternately. Nine cases were performed by extra-articular approach and 11 cases were performed by intra-articular approach. Every patient was observed in the outpatient clinic and visual analogue scale (VAS) was taken and compared before and after the procedure in all patients.
RESULTS
Pre-injection average VAS value of extra-articular approached cases was 5.22 +/- 1.99 and post-injection average VAS value was 4.11 +/- 1.96, which is statistically insignificant (p < 0.156). The average VAS value of intra-articular approached cases was decreased from 5.72 +/- 2.15 to 2.91 +/- 2.30 after injection, which is statistically significant (p < 0.006).
CONCLUSION
Ultrasound guided intra-articular approached steroid and local anesthetics injection could be effective in controlling pain for patients with femoroacetabular impingement syndrome.


MeSH Terms

Ambulatory Care Facilities
Anesthetics, Local
Femoracetabular Impingement
Humans
Anesthetics, Local

Figure

  • Fig. 1 Example of ultrasound-guided intra-articular steroid injection in a 40-year-old male patient. A. On ultrasound image before contrast injection, tip of 22-gauge 3.5-inch spinal needle is placed in the hip joint cavity (arrowhead). B. Intra-articular injection is performed. A hyperechoic line shows injectates (arrows). C. A fluoroscopic image is checked and this image shows intra-articular contrast filling of the hip joint.

  • Fig. 2 Example of ultrasound-guided extra-articular steroid injection in a 51-year-old female patient. A. On ultrasound image of extra-articular injection, tip of 22-gauge 3.5-inch spinal needle is placed at the undersurface of proximal rectus femoris muscle (arrowhead). A hyperechoic line shows injectates (arrows). B. A fluoroscopic image is checked and this image shows extra-articular contrast filling of the hip joint.


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