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Ultrasound of the Hip

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Musculoskeletal Ultrasound in Rheumatology Review

Abstract

Ultrasound of the hip is easy to perform and adds useful information to the physical exam, which in the hip has its particular limitations given the depth of the joint and periarticular soft tissues. This chapter provides instruction on how to obtain standard views of the anterior hip and extended standard views of the lateral hip. Important anatomy and findings in the normal hip are reviewed. Commonly encountered pathologies in the hip joint and periarticular soft tissues and imaging findings in greater trochanteric pain syndrome are illustrated. The development of an ultrasound scoring system for large joints in the inflammatory arthritides as it applies to the hip and the inclusion of hip ultrasound in the 2012 European League Against Rheumatism/American College of Rheumatology provisional classification for polymyalgia rheumatica are discussed. Next follows a demonstration of ultrasound-guided hip joint aspiration/injection as well as ultrasound-guided injection of the trochanteric bursa.

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References

  1. McAlindon T, Kissin E, Nazarian L, Ranganath V, Prakash S, Taylor M, et al. American College of Rheumatology report on reasonable use of musculoskeletal ultrasonography in rheumatology clinical practice. Arthritis Care Res (Hoboken). 2012;64(11):1625–40.

    Google Scholar 

  2. Backhaus M, Burmester GR, Gerber T, Grassi W, Machold KP, Swen WA, et al. Guidelines for musculoskeletal ultrasound in rheumatology. Ann Rheum Dis. 2001;60(7):641–9.

    Google Scholar 

  3. Schmidt WA, Hauer RW, Banzer D, Bohl-Bühler M, Braun J, Mellerowicz H, et al. Technik und Stellenwert der Arthrosonographie in der rheumatologischen Diagnostik. Teil 2: Sonographie der Hueftregion. Z Rheumatol. 2002;61:180–8.

    Google Scholar 

  4. Pfirrmann CW, Chung CB, Theumann NH, Trudell DJ, Resnick D. Greater trochanter of the hip: attachment of the abductor mechanism and a complex of three bursae – MR imaging and MR bursography in cadavers and MR imaging in asymptomatic volunteers. Radiology. 2001;221:469–77.

    Google Scholar 

  5. Robben SG, Lequin MH, Diepstraten AF, den Hollander JC, Entius CA, Meradji M. Anterior joint capsule of the normal hip and in children with transient synovitis: US study with anatomic and histologic correlation. Radiology. 1999;210:499–507.

    Google Scholar 

  6. Koski JM, Anttila PJ, Isomaki HA. Ultrasonography of the adult hip joint. Scand J Rheumatol. 1989;18(2):113–7.

    Google Scholar 

  7. Weybright PN, Jacobson JA, Murry KH, Lin J, Fessell DP, Jamadar DA, et al. Limited effectiveness of sonography in revealing hip joint effusion: preliminary results in 21 adult patients with native and postoperative hips. Am J Roentgenol. 2003;181(1):215–8.

    Google Scholar 

  8. Walther M, Harms H, Krenn V, Radke S, Kirschner S, Gohlke F. Synovial tissue of the hip at power Doppler US: correlation between vascularity and power Doppler US signal. Radiology. 2002;225:225–31.

    Google Scholar 

  9. Long S, Surrey D, Nazarian L. Common sonographic findings in the painful hip after hip arthroplasty. J Ultrasound Med. 2012;31:301–12.

    Google Scholar 

  10. Wunderbaldinger P, Bremer C, Schellenberger E, Cejna M, Turetschek K, Kainberger F. Imaging features of iliopsoas bursitis. Eur Radiol. 2002;12(2):409–15.

    Google Scholar 

  11. Bianchi S, Martinoli C, Keller A, Bianchi-Zamorani MP. Giant iliopsoas bursitis: sonographic findings with magnetic resonance correlations. J Clin Ultrasound. 2002;30(7):437–41.

    Google Scholar 

  12. Pelsser V, Cardinal E, Hobden R, Aubin B, Lafortune M. Extraarticular snapping hip: sonographic findings. Am J Roentgenol. 2001;176(1):67–73.

    Google Scholar 

  13. Klauser AS, Martinoli C, Tagliafico A, Bellmann-Weiler R, Feuchtner GM, Wick M, et al. Greater trochanteric pain syndrome. Semin Musculoskelet Radiol. 2013;17(1):43–8.

    Google Scholar 

  14. Long SS, Surrey DE, Nazarian LN. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. Am J Roentgenol. 2013;201(5):1083–6.

    Google Scholar 

  15. Bass CJ, Connel DA. Sonographic findings of tensor fascia lata tendinopathy: another cause of anterior groin pain. Skeletal Radiol. 2002;31:143–8.

    Google Scholar 

  16. Ruta S, Gutierrez M, Pena C, García M, Arturi A, Filippucci E, et al. Prevalence of subclinical enthesopathy in patients with spondyloarthropathy: an ultrasound study. J Clin Rheumatol. 2011;17(1):18–22.

    Google Scholar 

  17. Di Geso L, Filippucci E, Riente L, Sakellariou G, Delle Sedie A, Meenagh G, et al. Ultrasound for the rheumatologist XL. Sonographic assessment of the hip in rheumatoid arthritis. Clin Exp Rheumatol. 2012;30(4):464–8.

    Google Scholar 

  18. Riente L, Delle Sedie A, Sakellariou G, Filippucci E, Meenagh G, Iagnocco A, et al. Ultrasound imaging for the rheumatologist XXXVIII. Sonographic assessment of the hip in psoriatic arthritis patients. Clin Exp Rheumatol. 2012;30(2):152–5.

    Google Scholar 

  19. Sakellariou G, Iagnocco A, Meenagh G, Riente L, Filippucci E, Delle Sedie A, et al. Ultrasound imaging for the rheumatologist XXXVII. Sonographic assessment of the hip in ankylosing spondylitis patients. Clin Exp Rheumatol. 2012;30(1):1–5.

    Google Scholar 

  20. Hartung W, Kellner H, Strunk J, Sattler H, Schmidt WA, Ehrenstein B, et al. Development and evaluation of a novel ultrasound score for large joints in rheumatoid arthritis: one year of experience in daily clinical practice. Arthritis Care Res. 2012;64(5):675–82.

    Google Scholar 

  21. Schäfer VS, Fleck M, Kellner H, Strunk J, Sattler H, Schmidt WA, et al. Evaluation of the novel ultrasound score for large joints in psoriatic arthritis and ankylosing spondylitis: six month experience in daily clinical practice. BMC Musculoskelet Disord. 2013;14:358.

    Google Scholar 

  22. Dasgupta B, Cimmino MA, Kremers HM, Schmidt WA, Schirmer M, Salvarani C, et al. 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum. 2012;64(4):943–54.

    Google Scholar 

  23. Smith J, Hurdle MF, Weingarten TN. Accuracy of sonographically guided intra-articular injections in the native adult hip. J Ultrasound Med. 2009;28:329–35.

    Google Scholar 

  24. Byrd JW, Potts EA, Allison RK, Jones KS. Ultrasound-guided hip injections: a comparative study with fluoroscopy-guided injections. Arthroscopy. 2014;30(1):42–6.

    Google Scholar 

  25. Fessell DP, Jacobson JA, Craig J, Habra G, Prasad A, Radliff A, et al. Using sonography to reveal and aspirate join effusions. AJR Ann J Roentgenol. 2000;174:1353–62.

    Google Scholar 

  26. Labrosse JM, Cardinal E, Leduc BE, Duranceau J, Rémillard J, Bureau NJ, et al. Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR Am J Roentgenol. 2010;194(1):202–6.

    Google Scholar 

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Correspondence to Naina Rastalsky MD, FACR, RhMSUS .

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© 2016 Springer International Publishing Switzerland

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Rastalsky, N. (2016). Ultrasound of the Hip. In: Kohler, M. (eds) Musculoskeletal Ultrasound in Rheumatology Review. Springer, Cham. https://doi.org/10.1007/978-3-319-32367-1_7

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  • DOI: https://doi.org/10.1007/978-3-319-32367-1_7

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-32367-1

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