A hip injection with fluoroscopy is a common medical procedure used to treat chronic pain originating from the hip joint or surrounding structures. This technique involves injecting medication directly into the affected area using real-time X-ray imaging technology. The use of imaging ensures precision, which is necessary for the medication to reach the deep spaces of the hip. This targeted approach offers a reliable treatment option when conservative therapies have not provided adequate relief.
Conditions Treated and Injection Goals
The primary purpose of a fluoroscopy-guided hip injection is to address pain from specific conditions within and around the hip joint. Common targets include pain caused by osteoarthritis (the breakdown of joint cartilage), inflammation from bursitis or tendinitis, labral tears, hip impingement, or other inflammatory and degenerative conditions.
The procedure has two objectives: therapeutic and diagnostic. The therapeutic goal is achieved by delivering an anesthetic and a corticosteroid medication into the painful area. The anesthetic provides immediate, temporary pain relief, while the corticosteroid reduces inflammation over a longer period, often lasting several weeks to months.
The diagnostic goal is to confirm the exact source of the pain. If the pain is significantly reduced immediately after the injection of the numbing agent, it confirms the targeted joint space is the source of the symptoms. This information helps physicians determine the next steps in the treatment plan, such as physical therapy or further interventions.
Understanding Fluoroscopic Guidance
Fluoroscopic guidance is the core component of this procedure, differentiating it from a standard injection. Fluoroscopy is a medical imaging technique that uses a continuous X-ray beam to create a real-time, moving image, similar to a live video. This visualization is necessary because the hip joint is a complex, deep structure, making a “blind” injection unreliable and unsafe.
The guidance process begins after the skin is numbed with a local anesthetic. The physician uses the fluoroscope to guide a thin needle toward the precise target, such as the intra-articular space of the hip joint. To confirm placement, a contrast agent (dye) is injected through the needle. The contrast material is visible on the fluoroscopic image, confirming the needle tip is accurately placed within the intended space.
Once confirmed, the therapeutic medication mixture is delivered. This accuracy maximizes the effectiveness of the medication by ensuring it reaches the exact site of inflammation. It also minimizes the risk of inadvertently injecting the medication into surrounding soft tissues, blood vessels, or nerves, improving the procedure’s safety profile.
Patient Experience: Preparation, Procedure, and Recovery
Preparation
Patient preparation involves several steps to ensure safety and success. Patients are typically instructed to fast from solid food for a few hours before the appointment. It is often necessary to temporarily stop taking certain medications, particularly blood thinners, which must be discussed with the referring physician. Patients must also arrange for a driver, as they will not be permitted to operate a vehicle immediately following the procedure due to the use of anesthetic.
The Procedure
The entire visit, from check-in to discharge, usually takes about 30 to 60 minutes, with the injection itself lasting only a short time. The patient lies on an X-ray table, and the injection site is sterilized and numbed with a local anesthetic. The patient must remain still while the physician uses the fluoroscope to guide the needle and administer the medication mixture. Afterward, patients are monitored in a recovery area for a brief observation period, usually 20 to 60 minutes, to ensure there are no immediate adverse reactions.
Recovery and Risks
Following the procedure, patients may experience temporary soreness or discomfort at the injection site for 24 to 48 hours. This can be managed with ice packs and over-the-counter pain relievers. Patients are advised to rest for the remainder of the day and avoid heavy lifting or strenuous activity for at least the first 24 hours. Although the procedure is generally safe, rare risks include infection (about 1 in 1,000 cases), nerve damage, or an allergic reaction to the contrast dye.