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Ultrasound-guided hip joint injection is a joint injection in the hip, assisted by medical ultrasound. Hip and groin pain often presents a diagnostic and therapeutic challenge. The differential diagnosis is extensive, comprising intra-articular and extra-articular pathology and referred pain from lumbar spine, knee and elsewhere in the pelvis.
Ultrasound-guidance is a popular choice for injections, [5] but injections can also be done under CT or MRI-guidance. [4] [6] Controlled studies have found that for patients with suspected piriformis syndrome, botox injections into the piriformis are more effective than a placebo [22] and also more effective than just an anesthetic block alone.
The needle size, length and type should be selected based on the site, depth and patient's body habitus. 22–24G needles are sufficed for most injections. [1] As an example, ultrasound-guided hip joint injection [16] can be considered when symptoms persist despite initial treatment options such as activity modification, analgesia and physical ...
Injections deliver medication directly to the piriformis muscle through a needle. The needle is placed into the piriformis muscle with image guidance such as fluoroscopy, ultrasound, CT, or MRI. [2] [30] Ultrasound is a popular choice due to a balance of accuracy, accessibility, lack of radiation exposure, and affordability. [29] [2]
Ultrasound can ablate tumors or other tissue non-invasively. [4] This is accomplished using a technique known as high intensity focused ultrasound (HIFU), also called focused ultrasound surgery. This procedure uses generally lower frequencies than medical diagnostic ultrasound (250–2000 kHz), but significantly higher time-averaged intensities.
Modern portable ultrasound devices allow the user to visualize internal anatomy, including the nerves to be blocked, neighboring anatomic structures and the needle as it approaches the nerves. Observation of local anesthetic surrounding the nerves during ultrasound-guided injection is predictive of a successful block. [5]
To improve accuracy, ultrasound-guided techniques were developed. The original ultrasound-guided technique for injection of the GON was described by Greher and colleagues in 2010; it targets the nerve as it courses superficial to the obliquus capitis inferior muscle at the C1-C2 level. [1]
Neurolysis mediates the effects of alcohol and phenol injections but does not mediate the effects of BoNT injections. Phenol and alcohol are less expensive, faster acting, can treat larger areas, and can be re-administered or boosted in less than three months, however, those injections also require the patient to be sedated, cause muscle ...