Document Type
Article
Publication Title
Advances in Orthopedics
Abstract
Purpose: Intra-articular hip injection is a common procedure in the United States for a number of hip pathologies. While these injections are often performed under fluoroscopic guidance, ultrasound-guided injections and anatomic landmark injections are popular choices for physicians as well. This systematic review and meta-analysis aims to compare the accuracy of intra-articular hip injections between ultrasound-guided and anatomic landmark injections.
Methods: A search was conducted across MEDLINE/PubMed, Cochrane, and Embase databases to evaluate the accuracy of intra-articular hip injection techniques. The search used a combination of keywords and Medical Subject Heading (MeSH) terms. Titles and abstracts were screened for eligibility according to inclusion criteria. Full texts were screened and included if they met the eligibility criteria. Demographics and results of the studies were extracted from the articles that met the inclusion criteria.
Results: Thirteen relevant studies were found and included in this systematic review. Anatomic landmark injections had a wide range of accuracy, with most of the articles reporting accuracies in the 60%–70% range. Ultrasound injections had consistently high accuracy with greater than 90% accuracy in all studies. Ultrasound injections showed relatively quick procedure times. Ultrasound injections also had higher patient-rated convenience scores than fluoroscopic injections. Pooled statistics determined that ultrasound was more accurate compared to anatomical landmark injections (95.7% versus 80.9%, p < 0.05), and meta-analysis determined that ultrasound was about five times more accurate than anatomical landmark injections (OR: 5.18, p < 0.001).
Conclusion: Ultrasound injections are statistically significantly more accurate than anatomic landmark injections and provide high accuracy rates in skilled hands. However, ultrasound accuracy remains dependent on physician technical skill. Anatomic landmark injections may be considered unreliable due to the inaccuracy of the injections when compared with ultrasound.
Level of Evidence: IV.
DOI
10.1155/aort/5518632
Publication Date
2-25-2026
Keywords
accuracy, anatomic landmark injection, hip, injection, ultrasound
ISSN
2090-3472
Recommended Citation
Puga TB, Box MW, Perleberg T, Pautler B, O'Connor KP, Riehl JT. Comparison of Intra-Articular Hip Injections Using Ultrasound or Anatomic Landmarks: A Systematic Review and Meta-Analysis. Advances in Orthopedics. 2026; . doi: 10.1155/aort/5518632.
