Abstract
Introduction
It is not uncommon to encounter patients with atypical hip or lower extremity pain, ill-defined clinico-radiological features and concomitant hip and lumbar spine arthritis. It has been hypothesized that an anaesthetic hip arthrogram can help identify the source of pain in these cases. The purpose of this study is to analyze our experience with this technique in order to verify its accuracy.
Methods
We undertook a retrospective analysis of 204 patients who underwent a hip anesthetic-steroid arthrogram for diagnostic purposes matching our inclusion criteria. Patient charts were scrutinized carefully for outcomes of arthrogram and treatment. Harris Hip Score was used to quantify outcome.
Results
The results show that out of 204, 162 patients had positive and 42 had negative response to arthrogram. Of the positive responders (N=162), 76 underwent uncemented Total Hip Arthroplasty (THA), all with good results, and the rest are being treated conservatively. From the negative responder group (N=42), 33 were successfully treated for spinal and other disorders, 8 underwent successful THA and 1 had an unsuccessful THA.
Conclusion
Our findings suggest that the relief of symptoms following instillation of local anaesthetic and steroid into the hip joint has a positive predictive value and specificity of 100%, sensitivity of 95% and negative predictive value of 89.5%. We thereby believe that this is useful and reliable test with low morbidity for distinguishing between pain arising from the hip and other sources and can predict the potential benefit of THA in this diagnostic challenging group of patients.
