What is hip arthrography?

The hip joints are ball-and-socket type joints formed by the pelvis (acetabulum) and thigh (femur). Various medical conditions - such as osteoarthritis, trauma, and congenital abnormalities - can cause the hip to be painful. The hip joint lies deep in the body and can radiate pain to the groin, thigh, and buttock. A hip arthrogram is a precision injection which places medication into the hip joint under x-ray guidance.

Why is arthrography helpful?

Hip arthrography can be helpful in two ways. In many instances your primary physician or orthopedist may have ample reason to suspect that your hip is causing you pain. He or she may then refer you for a therapeutic hip arthrogram to help combat your pain. Under other circumstances the source of your pain may be unclear. Your primary physician or orthopedist may then refer your for a diagnostic hip arthrogram to help identify the source of your pain.

What will happen to me during the procedure?

You will be positioned on your side with the painful hip up. Your skin will be well cleaned and draped to create a ‘sterile field’. Next the physician will numb your skin with some anesthetic medicine. After your skin has been numbed, the physician will use x-ray guidance to direct a small needle into your hip. You may feel temporary discomfort as the needle passes through the skin and muscles. Once the needle is in place a small amount of contrast material will be injected into hip to confirm proper placement of the medicine. Finally, after having confirmed that the needle is properly placed, a small amount of cortisone and/or numbing agent will be placed directly into the hip joint.

What should I do after the procedure?

You will wait 15-30 minutes before going home. You may develop some weakness in the leg muscles as the numbing agent placed into the joint leaches out into the surrounding tissues. Because of this you may not drive for 8 hours after the injection.

Potential Complications

With any procedure there are potential complications. You and your doctor should discuss these before being referred for a hip arthrogram. We believe that in carefully selected patients the potential benefits from a hip arthrogram outweigh the potential harms. Potential complications or risks may include, but are not limited to:

1. If you are a diabetic and you receive a cortisone injection, your blood sugar will increase for 48 hours and you will need to monitor this.
2. Infection is a remote possibility whenever a needle is introduced under the skin. To prevent this complication your skin will be disinfected and carefully prepared using strict sterile technique. If an infection in the hip joint develops, this is a serious complication and it will require intensive antibiotic treatment and possibly surgery.
3. Local bleeding can rarely be significant and require further treatment.
4. There is remote potential for nerve injury, which can lead to permanent pain and /or weakness.
5. Allergic/adverse reaction can develop to medications and substances used during the procedure: Betadine (contain iodine), anesthetics, contrast agents, corticosteroids. Side effects of corticortisteroids include increased blood sugar, increased blood pressure, mood swings, fluid retention that can exacerbate existing heart failure, local fat atrophy, facial flushing, skin discoloration, gastritis or peptic ulcer disease, bone demineralization and necrosis of the hip.
6. Risks of conscious sedation include, but are not limited to allergic reactions to medications, post-procedure psychological problems such as hallucination, potential for over sedation, potential breathing problems, lack of blood flow and oxygen to vital organs such as the brain and the heart, which creates the risk of major complications such as stroke, heart attack or potentially even death.
7. Although most patients will benefit from the procedure, there is no guarantee of the desired results. Some patients will have a severe flare up in their pain for 1-2 weeks after an injection. In some individuals, this increase in pain can last longer, or in rare cases, even be permanent.

General Pre/Post Procedure Instructions

1. You should REFRAIN FROM EATING AND DRINKING 8 HOURS prior to the procedure EXCEPT for taking sips of plain water with medication (see below).
2. If you are taking oral (pill form) diabetes medication, DO NOT take this medication the morning of the procedure.
3. Take all other routine medications before the procedure (such as high blood pressure medication and insulin injection), including the morning of the procedure, with sips of water. If you are taking insulin injection, inject only HALF of the usual scheduled dose the morning of the procedure.
4. STOP ASPIRIN and any medication that contains aspirin, such as Excedrin, 7 DAYS PRIOR to the prodecure.
5. If you are taking Coumadin/Warfarin, heparin, Lovenox/Enoxaparin, please call the Coumadin Clinic at your local Kaiser facility or the physician who prescribed the medication prior to your visit.
6. If you are taking Plavix/Clopidogrel, Ticlid/Ticlopidine, or Pletal/Cilostazol, you must notify our office no later than 2 weeks prior to the procedure so that the timing of stopping these medicines can be explained.
7. You will need to bring a driver with you who is available to wait for you during the procedure. You may return to your current level of activities the next day, including return to work.
8. If you are on antibiotics, please notify our office, we may postpone the procedure until you have finished the medicine.
9. If you have an active infection or fever, we will not perform the procedure.
10. If you are a woman of childbearing age and you know or suspect that you may be pregnant, we will not perform the procedure.
11. If you have a known allergy – rash, hives, or anaphylaxis – to iodinated contrast agents, please contact our office 1week prior to your procedure.
12. You will be in the hospital for 2-3 hours even though you will see the physician for only 20 to 30 minutes.
13. You may return to your current level of activities the next day, including return to work.
14. If you have a recent hip X-ray or MRI which was not performed at Kaiser Permanente you must hand carry it with you to your visit. Failure to do so may result in rescheduling of the procedure.

Cortisone inhibits the body’s response to fight infection. Cortisone injections should not be given if there is an active infection elsewhere in your body. This is an elective procedure. If you have fever, chills, have a cold or flu or any infection, you should call to cancel the procedure. You should also call to cancel the procedure if you have recent (since booking this procedure) exacerbation of heart failure, heart attack, stroke or transient ischemic attack.

For cancellation or rescheduling procedures: Call (510) 675-4540

IF YOU NEED TO CANCEL THE PROCEDURE THE DAY OF YOUR APPOINTMENT, PLEASE CALL THE KAISER FREMONT AMBULATORY SURGERY CENTER DIRECTLY AT (510) 248-5650.

Place of Procedure

Your procedure will be performed at the Kaiser Fremont Ambulatory Surgery Center, located on the ground floor of the Embarcadero Building, Kaiser Fremont Hospital, 39400 Paseo Padre Parkway, Fremont, CA 94538.

Appointment Date:_____________________________________________________

Appointment Time:_____________________________________________________

Physician: ____________________________________________________________

NOTE: Please arrive ONE HOUR PRIOR to the appointment time to allow necessary preparation for the procedure. Failure to do so will result in rescheduling of the procedure.