Comparison of ultrasound- and fluoroscopy-guided intra-articular corticosteroid injections for hip osteoarthritis

Objectives: This study aimed to evaluate the effectiveness of ultrasound (US)-guided and fluoroscopy (FL)-guided intra-articular steroid injections on pain and hip function. The study focused on patients with hip osteoarthritis (coxarthrosis) who were refractory to medical treatment.
Methods: In this retrospective study, 61 patients with stage ≥2 coxarthrosis and VAS ≥4 were evaluated. Patients received either US-guided (Group U) or FL-guided (Group F) corticosteroid injections. Visual analog scale (VAS), Harris Hip Score (HHS), and analgesic use were assessed at 1 week and at 1, 3, and 6 months post-treatment. Analgesic use was evaluated based on the number of days with analgesic consumption and was interpreted as increased, decreased, or unchanged compared to baseline.
Results: Both treatment methods provided significant improvements in VAS and HHS scores at all follow-up points across osteoarthritis stages (p<0.05). However, no statistically significant difference was found between the groups in terms of pain scores, functional outcomes, or analgesic use. While marked improvements were observed in stage 2 patients, the clinical effectiveness of the injections decreased as the disease stage progressed.
Conclusion: Both US-guided and FL-guided steroid injections resulted in significant pain reduction and improved functionality in patients with osteoarthritis. No clear superiority was observed between the two techniques. Treatment was most effective in patients at earlier stages of the disease, with efficacy declining as the disease advanced. Additionally, US is a safer imaging modality compared to FL, as it does not involve exposure to ionizing radiation.

Keywords: Coxarthrosis, fluoroscopy, hip osteoarthritis, intraarticular corticosteroid injection, ultrasonography.