Ultrasound Guided Cortisone Injections of the Hip


Hip joint injections involve injecting medicine directly into the hip joint to diagnose the source of the pain or treat pain due to conditions which can cause inflammation in the hip such as arthritis, injury, or mechanical stress of the hip joint.  Hip pain may be experienced in the hip, buttock, leg, or lower back.  The injection solution is a combination of a numbing medicine (Lidocaine or Marcaine) and a cortisone (anti-inflammatory).  The numbing medicine delivers temporary pain relief, provided the hip is the source of the joint pain.  It thus serves a diagnostic function and helps to confirm or deny whether the joint is the source of the pain.  Cortisone serves to reduce the inflammation in the joint providing long term pain benefit

Procedure

The procedure involves placing an ultrasound probe over the hip joint.  Once the hip joint is visualized, a numbing spray is applied over the skin to minimize the sensation of the needle entering the skin.  A small caliber needle is then introduced into the joint.  The patient may feel a sting for a few seconds.  A combination of anesthetic and anti-inflammatory cortisone is then slowly injected into the joint. 

After the procedure

After the procedure, the patient is made to rest for 20-30 minutes and then asked to move the joint.  The patient may or may not find a decrease in pain depending on whether the injected joint is the primary source of pain for the patient.  The patient is also asked to maintain a record of relief in pain during the coming week.  Physical therapy may also be prescribed.  If the patient does experience pain relief, they should increase their activities gradually over the next few weeks to avoid recurrence of pain or inflammation

Risks and Complications

The possible risks of hip injections include: swelling and pain in the hip joint after injection, and in rare instances infection or local skin depigmentation

If the injected hip joint is the source of the pain, the patient may notice a reduction in pain after two to five days of the hip injection.  This is due to the delayed onset of action of cortisone.  If no improvement is found within 10 days of the injection, further diagnostic tests may be required to ascertain the cause of the pain.