Keywords:
Interventional non-vascular, Musculoskeletal system, Musculoskeletal joint, Ultrasound, Puncture, Treatment effects, Pathology
Authors:
I. G. Burrelli1, E. Tarabelli1, R. Giuliani1, P. Vagli2, L. Faggioni2, C. Vignali1, L. Turturici2; 1Lido di Camaiore/IT, 2Pisa/IT
DOI:
10.1594/ecr2013/C-1454
Purpose
Degenerative osteoarthrosis of the hip joint is the most common chronic disease of the hip joint in adults.
Patients suffering from hip osteoarthrosis are frequently symptomatic and the disease can result in significant limitation of patients' activity and high social costs.
The diagnosis is based on a combination of characteristic clinical symptoms (pain,
stiffness and functional limitation) and radiographic findings (joint space narrowing,
development of osteophytes,
subchondral demineralisation/sclerosis and cyst formation,
loose bodies,
joint malalignment and deformity).
The radiologists read pelvic radiographs using the Kellgren-Lawrence radiographic grading scales to determine the presence and severity of osteoarthrosis of the hip.
Kellgren-Lawrence classification includes:
- Grade 0: No radiographic findings of osteoarthrosis
- Grade 1: Minute osteophytes of doubtful clinical significance
- Grade 2: Definite osteophytes with unimpaired joint space (fig.1)
- Grade 3: Definite osteophytes with moderate joint space narrowing (fig.2)
- Grade 4: Definite osteophytes with severe joint space narrowing and subchondral sclerosis (fig.3)
Hip osteoarthrosis is generally managed with systemic treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs),
physiotheraphy and weight loss.
Ultrasound-guided intra-articular injections of hyaluronic acid (viscosupplementation-viscoinduction),
which aims to restore the physiological lubricating properties of the synovial fluid and stimulates the endogenous secretion of hyaluronic acid by the synovial cell of the hip joint,
is now a routinely prescribed treatment for osteoarthrosis of the knee.
However,
few data exist in the literature regarding the use of viscosupplementation-viscoinduction in the treatment of hip osteoarthrosis.
The objective of this study is to evaluate the efficacy of intra-articular injection,
under ultrasound control,
of hyaluronic acid in patients with hip symptomatic osteoarthrosis.