Air arthrography: a safe technique for intra-articular hip injections

Area of Science:

• Orthopedic Surgery
• Radiology
• Pain Management

Background:

• Diagnosing young adult hip pain is challenging due to non-specific symptoms.
• Fluoroscopy-guided injections are crucial for differentiating intra-articular from extra-articular hip pain.
• Accurate needle placement is critical for effective hip joint injections.

Purpose of the Study:

• To present the air arthrography technique for intra-articular hip injections.
• To assess the outcomes and complications of air arthrography in a patient cohort.
• To evaluate air arthrography as a safe, cost-effective alternative to contrast media.

Main Methods:

• Retrospective review of 352 hips in 294 patients undergoing air arthrography guided hip injections (April 2019 - September 2022).
• Evaluation of patient records for complications related to injection or subsequent hip surgery.
• Analysis of complication rates, steroid flares, and infective complications.

Main Results:

• A low complication rate of 2.56% was observed, primarily steroid flares that resolved without intervention.
• No infective complications occurred following injections or subsequent hip surgeries.
• 102 patients underwent subsequent hip surgery with a mean follow-up of 346 days post-procedure.

Conclusions:

• Air arthrography is a reliable, safe, and cost-effective method for intra-articular hip injections.
• This technique avoids the risks associated with contrast media.
• This study provides the first evaluation of longer-term outcomes following air arthrography guided injections.