Accuracy and efficacy of intra-articular hip injections under ultrasound guidance versus landmark and fluoroscopy guided injections: A systematic review
Alia Hemeida1, Donald Kasitinon1, Lindsey Kim1, Reed Williams2, Levent Özçakar3, Nitin B. Jain4
1Department of Physical Medicine and Rehabilitation, The University of Texas Southwestern, Dallas, TX, USA
2Summit Orthopedics, Twin Cities, MN, USA
3Department of Physical Medicine and Rehabilitation, Hacettepe University Faculty of Medicine, Türkiye
4Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
Keywords: Fluoroscopy, hip, injection accuracy, intra-articular, pain outcomes, ultrasound.
Abstract
Objectives: In this systematic review, we discuss the literature regarding the accuracy and efficacy of ultrasound (US)-, fluoroscopy (FL)-, and landmark (LM)-guided intra-articular hip injections.
Materials and methods: A systematic review was performed following the Cochrane process from April 2023 to August 2023 utilizing PubMed, Embase, Web of Science, and Scopus databases. Branched logic was used to include any articles that were published prior to April 2023 containing the key terms “hip” AND “ultrasound” AND “injections”. Two authors screened studies for eligibility, and any disagreements were resolved through discussion with a third reviewer. Risk-of-bias assessments were performed.
Results: A total of five studies were included in the review. Individual studies demonstrated amounted to 100% (17/17) versus 85.4% (53/62) versus 70% (52/74) for US-, FL- and LM-guided intra-articular injections/arthrocentesis, respectively. All studies, except for one, addressing either the injection accuracy or improvement in pain showed improved outcomes in the US-guided injection/aspiration groups.
Conclusion: This systematic review provides preliminary evidence for slightly better accuracy with US-guided intra-articular hip injections/arthrocentesis versus FL- or LM-guided intra-articular hip injections/aspirations. It contributes to the current literature by evaluating multiple measurable outcomes, including procedural accuracy, changes in pain scores, patient-reported procedural discomfort, and improvements in range of motion.
Citation: Hemeida A, Kasitinon D, Kim L, Williams R, Özçakar L, Jain NB. Accuracy and efficacy of intra-articular hip injections under ultrasound guidance versus landmark and fluoroscopy guided injections: A systematic review. Arch ISPRM 2026;1(x):i-viii. https://doi.org/10.5606/ archisprm.2026.10.