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Ultrasound-Guided Injection Techniques for the Low Back and Hip Joint

Chen, Carl P.C. MD, PhD; Lew, Henry L. MD, PhD; Tsai, Wen-Chung MD, PhD; Hung, Yu-Ting MD; Hsu, Chih-Chin MD, PhD

American Journal of Physical Medicine & Rehabilitation: October 2011 - Volume 90 - Issue 10 - pp 860-867
doi: 10.1097/PHM.0b013e318228c084
Invited Review: Ultrasound

Ultrasound has become a useful adjunct to many procedures performed in rehabilitation medicine. It has the advantages of cost-effectiveness, lack of radiation, and readiness of use and the ability to make dynamic examinations possible compared with other imaging tools. Through dynamic examinations, needles can be guided accurately to the target sites to increase the success rates of aspiration and injection procedures. At present, ultrasound-guided caudal epidural, sacroiliac joint, piriformis muscle, and hip-joint injections are commonly practiced in rehabilitation medicine. Perhaps the only disadvantage of ultrasound-guided injection technique is the long learning curve that is required for the physiatrists to be well acquainted with the simultaneous manipulation of ultrasound transducers, placement of needles, and the correct interpretation of musculoskeletal sonographic images. This is the first of two review articles on ultrasound-guided injections. This article will review the selected ultrasound-guided injection techniques that are performed in the low-back and hip-joint areas. Sonographic images and schematic illustrations of these ultrasound-guided injection techniques will be shown.

From the Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Linkou and Chang Gung University School of Medicine, Gueishan Township, Taoyuan County, Taiwan (CPCC, W-CT, Y-TH); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Defense and Veterans Brain Injury Center (DVBIC), Richmond, Virginia (HLL); and Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Keelung and Chang Gung University College of Medicine, Gueishan Township, Taoyuan County, Taiwan (C-CH).

All correspondence and requests for reprints should be addressed to: Chih-Chin Hsu, MD, PhD, Associate Professor, Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Keelung, No 222, Mai-Jin Road, Keelung 204, Taiwan.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2011 Lippincott Williams & Wilkins, Inc.