Outcome Analysis of USG Guided Musculoskeletal Interventions in the HIP Using MRI and USG Correlation

Abstract

Introduction: Hip pain is a common condition reported by patients and will probably continue to grow in prevalence. There are many potential causes of musculoskeletal pain related to the hip. Structures from which this pain is generated include the hip joint itself, the surrounding musculotendinous structures, and numerous lumbar nerve branches innervating the hip region. Ultrasound is increasingly being used to guide diagnostic and therapeutic interventions around the hip joint. Ultrasound eliminates the necessity for radiation exposure and is already the method of choice for hip joint aspiration, an intervention that may be useful in guiding surgery. US-guided injections to manage hip pain have emerged as valuable tools for diagnostic and therapeutic applications. These injections can(a) help narrow.w the list of possible sources of pain,(b) serve as a primary method of managing pain, and/or(c) serve as a bridge to delayed surgery. Aims and Objective: 1. To identify the clinical manifestations and imaging findings of common hip conditions that may warrant US-guided intervention.2. To assess the potential complications and expected outcomes associated with US-guided hip intervention. Materials and Methods: The study is carried out in department of Radiodiagnosis, GMCH,Guwahati.Patients with history of hip pain with osteoarthritis, rheumatoid arthritis, GTPS, bursitis, tendinopathy etc referred to the department of radiology. The ultrasound study was performed on Samsung” RS80A with PRESTIGE” machine using high frequency 3-12 MHz advanced piezoelectric crystal design linear array transducer. MRI evaluation was performed on 1.5Tesla SIEMENS MAGNETOM AVANTO FIT machine. Discussion: Total of 40 patients who presented with clinical signs and symptoms of Osteoarthritis, GTPS, Septic arthritis and Iliopsoas bursitis were enrolled in the study and underwent high-resolution USG guided intervention both as diagnostic and therapeutic purpose(Out of 40 patients 20 patients are having osteoarthritis,8 patients having septic arthritis, 7 patients having iliopsoas bursitis and 5 patients having GTPS).This was followed by pre and post treatment MRI of the affected hip and the findings were correlated. Conclusion: Ultrasonography is an effective imaging modality for diagnosing hip pathology after radiograph predominantly in detection of joint effusion and synovial thickening. Various ultrasound-guided diagnostic and therapeutic injections can be considered in patients with hip or groin pain. MRI is a more appropriate investigation and is therefore considered as the gold standard.