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Hip pain is a common clinical complaint and a source of disability with an incidence of 12 to 15 percent among all adults over the age of 60 years. Therapeutic hip joint injection with corticosteroids, hyaluronic acid, and plasma-rich platelets have formed the cornerstone of non-surgical management of hip pain. This activity outlines and explains the role of the fluoroscopy-guided hip joint injections, and the technique required for therapeutic hip joint injections for patients. Objectives: Summarize the steps involved in performing a hip joint injection in patients with hip pain and summarize key patient safety points. Describe the typical imaging findings associated with hip joint arthrography. Outline the importance of proper technique when performing a hip joint injection. Review the importance of collaboration between interprofessional team members caring for patients requiring hip joint injections, to improve clinical outcomes. Access free multiple choice questions on this topic.

Hip pain is a common clinical complaint and a source of disability with an incidence of 12 to 15 percent among all adults over the age of 60 years.[1][2] Radiographic hip osteoarthritis affects 27% of adults above the age of 45 years.[3] A lifetime risk of 25% is seen in those who are older than 85 years of age and with a 10% lifetime risk for eventual total hip replacement.[4][5] Osteoarthritis of the hip involves a progressive loss of articular cartilage. Subchondral cysts, osteophyte formation, and synovial inflammation can subsequently develop. Therapeutic hip joint injection with corticosteroids, hyaluronic acid, and plasma-rich platelets have formed the cornerstone of non-surgical management of hip pain. The important aspects of a fluoroscopic guided hip joint injection include: Minimize patient discomfort Maintain patient safety Maintain proper needle technique in accessing the intraarticular joint space

Complications are rare and include: Exacerbation of baseline pain, especially the night of the procedure which may be related to bland synovitis Allergic reaction Small vessel injury The patient's prior imaging should be reviewed to assess for aberrant/variant anatomy.

The role of a radiology technologist is exceptionally important in helping the operator during the procedure. Patient comfort is critical in properly performing the procedure as significant patient movement can affect satisfactory targeting of the hip joint. Movement can also affect needle trajectory with a potential injury of the femoral neuro-vasculature. The technologist plays an important role in assisting in fluoroscopic image acquisition. Documentation of immediate pain relief is important for the referring provider, as this can help further manage treatment.