Steroid injection for hip osteoarthritis: efficacy under ultrasound guidance

The objective of this study was to determine the efficacy of IA corticosteroid (CS) injection in pain reduction for hip OA under ultrasound (US) guidance.  Forty patients [mean age 62.78 (8.16) years] fulfilling ACR criteria for hip OA, with synovitis detected at US, gave their consent for IA US-guided CS injection because of pain refractory to conventional therapy. At baseline, at 1 and 3 months, patients filled up a visual analogue scale (VAS) pain on walking, performed the Lequesne index and were checked by US for synovitis. Results were compared with age-matched controls. The occurrence of side effects both short and long term was monitored.  IA steroid deposition was performed under US guidance. After 1 and 3 months, walking pain VAS was significantly reduced vs baseline (P < 0.001) and had high correlation with Lequesne index. Synovial hypertrophy was reduced in 75% of the hips after 1 and 3 months vs baseline (P < 0.001). In the group of controls, hip walking pain VAS, Lequesne index and synovial hypertrophy were not changed at 3 months vs baseline (P > 0.05). Transient facial rash was present in 16 patients during the first 24–48 h after injection. No side effects were reported.

US-guided steroid injections in hip OA is an efficacious and safe therapeutic approach to achieve pain control and reduction of synovial hypertrophy avoiding the use of X-ray-guided procedure.

Mihaela C. Micu, Gheorghe D. Bogdan and Daniela Fodor. Steroid injection for hip osteoarthritis: efficacy under ultrasound guidance.