Steroid injection for hip osteoarthritis: efficacy under ultrasound guidance

Rheumatology (Oxford). 2010 Aug;49(8):1490-4. doi: 10.1093/rheumatology/keq030. Epub 2010 Mar 24.


Objective: To determine the efficacy of IA corticosteroid (CS) injection in pain reduction for hip OA under ultrasound (US) guidance.

Methods: Forty patients [mean age 62.78 (8.16) years] fulfilling ACR criteria for hip OA, with synovitis detected at US, gave their consent for IA US-guided CS injection because of pain refractory to conventional therapy. At baseline, at 1 and 3 months, patients filled up a visual analogue scale (VAS) pain on walking, performed the Lequesne index and were checked by US for synovitis. Results were compared with age-matched controls. The occurrence of side effects both short and long term was monitored.

Results: IA steroid deposition was performed under US guidance. After 1 and 3 months, walking pain VAS was significantly reduced vs baseline (P < 0.001) and had high correlation with Lequesne index. Synovial hypertrophy was reduced in 75% of the hips after 1 and 3 months vs baseline (P < 0.001). In the group of controls, hip walking pain VAS, Lequesne index and synovial hypertrophy were not changed at 3 months vs baseline (P > 0.05). Transient facial rash was present in 16 patients during the first 24-48 h after injection. No side effects were reported.

Conclusion: US-guided steroid injections in hip OA is an efficacious and safe therapeutic approach to achieve pain control and reduction of synovial hypertrophy avoiding the use of X-ray-guided procedure.

MeSH terms

  • Aged
  • Antirheumatic Agents / administration & dosage*
  • Case-Control Studies
  • Humans
  • Injections, Intra-Articular / methods
  • Middle Aged
  • Osteoarthritis, Hip / drug therapy*
  • Pain Measurement
  • Statistics as Topic
  • Steroids / administration & dosage*
  • Treatment Outcome
  • Ultrasonography, Interventional / methods


  • Antirheumatic Agents
  • Steroids