Fluoroscopically-guided Joint and Bursa Injection Techniques: A Comprehensive Primer

Fluoroscopic-guided procedures of the lower extremity

“…For a straight vertical approach, the access needle is advanced perpendicular to the fluoroscopy beam with the hub directly over the needle tip (the “bull’s eye” approach) [ 1 , 3 , 16 ]. When the needle hits bone or is felt to enter the joint space, a test injection of local anesthetic is made.…”

“…Hip injections are most commonly performed to alleviate pain or to confirm an intraarticular source of pain [ 16 ]. CT or MR arthrograms enable assessment of labral or chondral injury and intraarticular bodies.…”

“…CT or MR arthrograms enable assessment of labral or chondral injury and intraarticular bodies. Concern for infection in a painful native hip or prosthesis is the most common reason to perform a hip aspiration [ 16 ]. Approximately 15% of all adult cases of SA involve the hip (Fig.…”

“…The zona orbicularis, or annular ligament, is a circumferential, band-like thickening of the joint capsule which can cause a normal constriction at the femoral head-neck junction (Fig. 1 ) [ 9 , 10 , 16 , 65 ]. Additionally contrast instillation can help visualize a paralabral cyst associated with a labral tear [ 66 ].…”

“…9 ). In these postoperative patients, the operator may feel different tissue resistance when compared to a native hip either due to capsular disruption or scar tissue formation [ 16 ]. This subset of patients may also need additional local anesthetic as these aspirations can be more painful than a native hip due to the postoperative scarring.…”