Hip and Pelvis Procedures
KEY FACTS
Procedure
Synovial biopsy accurate for confirming or excluding joint infection if no fluid to aspirate
Histology allows early assessment as to likelihood of TB infection
If multinucleated giant cells or caseating granulomas on histology, can treat empirically until culture available in 2-6 weeks
Similarly, if no histologic features of TB & gram stain positive, can treat empirically as non-TB infection until culture available in 2-6 days
Longitudinal US in 3-month-old boy with fever, limited movement, and clinically suspected septic arthritis shows a small hip effusion 
. The femoral head 
is, as yet, not ossified.
US-guided percutaneous aspiration 
yielded a small amount of purulent fluid. This grew Staphylococcus aureus. No sedation was required. US-guided aspiration allows an early and accurate diagnosis of joint infection. Occasionally, septic arthritis is associated with only a small joint effusion.
Longitudinal US shows moderate to severe tendinosis of the hamstring attachment to the ischial tuberosity. There is thickening of the hamstring tendons 
with irregularity of the ischial tuberosity 
attachment area.
Longitudinal US shows 20-g spinal needle 
within hamstring tendons 
during injection of 8 mL of platelet-rich plasma (PRP). Prior to PRP injection, the hamstring tendons were fenestrated for 1 min by moving the spinal needle to and fro through the tendon substance.
PREPROCEDURE
Indications
Getting Started
PROCEDURE
Procedure Steps
US-guided joint injection is as effective as & quicker than fluoroscopic-guided joint injection
Hip joint injection
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