Hip-Spine Syndrome: The Diagnostic Utility of Guided Intra-articular Hip Injections
Authors: Maldonado DR, Mu BH, Ornelas J, Chen SL, Lall AC, Walker-Santiago R, Rosinsky PJ, Shapira J, Domb BG
DOI: 10.3928/01477447-20191223-05
Background:
Hip-Spine Syndrome describes patients with concurrent hip and lumbar spine pathology, often presenting with overlapping symptoms that challenge diagnostic accuracy. This study assesses the role of ultrasound- and fluoroscopy-guided intra-articular hip injections in localizing the source of pain.
Methods:
Nine studies were reviewed, examining the diagnostic performance of guided intra-articular injections in patients with suspected hip-spine syndrome.
Key Findings:
- Intra-articular injections demonstrated high diagnostic accuracy, with:
- Sensitivity: 93.6%
- Specificity: 95.0%
- Positive Predictive Value: 98.8%
Conclusions:
Guided intra-articular hip injections are highly reliable in differentiating intra-articular hip pathology from spinal sources in patients with complex lumbopelvic pain.
What Does This Mean for Providers?
- Use guided intra-articular hip injections as a diagnostic adjunct in patients with uncertain pain origins between the hip and spine.
- High accuracy rates support this tool in surgical planning, helping to avoid unnecessary or misdirected interventions.
- Early application may streamline treatment pathways and improve multidisciplinary care coordination in orthopedics, physiatry, and spine care.