Do we need radiological guidance for hip joint injections?

Intra-articular injections are widely used in treatment of early hip osteoarthritis and may help to offset the need for a joint replacement. Most orthopaedic surgeons do this under radiological guidance while some rheumatologists and pain specialists do it without. Our study was aimed at assessing accuracy of blind intra-articular injections to the hip joint. Forty-three hips in 40 consecutive patients who had hip injections were included in the study. The anatomical landmarks were marked and the needle was placed from an antero-lateral approach. Radio-opaque dye was then injected and the position of the needle was checked under image intensifier. The success rate of blind injections was 65.1%. Obese patients, patients with severe grade 4 arthritis with no joint space and those with flexion deformity were the majority of failed cases. We propose that hip injections should be carried out by trained specialists under radiological guidance.