Houston Methodist. Leading Medicine

Hip FAQ

Question:

I need an injection for my hip arthritis. The last one I had required the use of X-rays. I also have a history of cancer and received radiation treatments. I'd like to avoid any more radiation if possible. Can they use the old X-rays to just do this injection without taking new ones?

Answer:

Intra-articular (into the joint) injections of the hip can be helpful in alleviating painful symptoms from osteoarthritis. Careful technique is required on the part of the physician performing the injection. Blind injections (guided only by vision and touch) are less expensive than injections performed with imaging. Blind injections can be done right in the physician's office. And the patient isn't exposed to radiation. But blind injections are not advised. For complete accuracy, imaging and arthrography are required. Arthrography is the use of a contrast dye injected into the joint to show that the injected agent actually made it into the joint. Studies show that with blind injections you have a 50-50 chance of success. Using the blind technique with any success is like tossing a coin and shouting heads or tails and then being right (or wrong). Using previous X-rays isn't helpful because arthritis changes the shape and structure of the joint. In other words, it could be a different looking joint even from the last time it was X-rayed. And most of the X-ray techniques are real-time, which means the surgeon sees in 3-D, the joint, the soft tissue structures in and around the joint, and the needle placement as it advances forward through the soft tissues into the joint space. Talk to your orthopedic surgeon about your concerns. Find out how much radiation you would be exposed to and what other options you may have. Some physicians are using ultrasound now instead of X-ray imaging. There's no exposure to radiation and it can be followed up with arthrography to ensure 100% accuracy. Demirhan Duracoglu, MD, et al. Evaluation of Needle Positioning During Blind Intra-Articular Hip Injections for Osteoarthritis: Fluoroscopy Versus Arthrography. In Archives of Physical Medicine and Rehabilitation. December 2009. Vol. 90. No. 12. Pp. 2112-2115.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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