ABSTRACT
Complex joint anatomy may render the clinical diagnosis of a patient with joint pain
difficult. Pain may be referred to a joint from an adjacent area (e.g., from the back
to the hip) making the diagnosis difficult. The radiologist with the use of fluoroscopy
is the ideal person to perform diagnostic and therapeutic joint injections. Long-acting
anesthetic alone or combined with a corticosteroid may help the clinician localize
the cause of the joint pain and subsequently institute the proper therapy. This article
includes a discussion of the commonly used injectable corticosteroids that are available.
The choice of corticosteroid is based on personal preference. Depomedrol (Upjohn,
Kalamazoo, Ml) is the least expensive corticosteroid available; however, a relatively
insoluble drug such as Aristospan (Lederle, Deerfield, IL) or a combination drug such
as Celestone Soluspan (Schering, Kenilworth, NJ) may be a better choice in rheumatoid
arthritis. The technique used to inject the hip and the shoulder is discussed.
KEYWORDS
Corticosteroids - joint, injection - fluoroscopy - hip abnormalities - interventional
procedures - arthrography
