Ultrasound and computed tomography-guided interventions for the hip joint and pelvis: Comprehensive imaging review

Diagnosing the underlying cause of hip pain can be challenging, often requiring extensive clinical and imaging workup. Current definitive treatments, while effective, frequently involve invasive surgical procedures with inherent risks, potential complications, and the possibility of complex revision surgeries. For radiologists, ultrasound (US)- and computed tomography (CT)-guided musculoskeletal interventions offer compelling, minimally invasive, and cost-effective alternatives. These image-guided techniques provide precise, real-time visualization, enabling accurate diagnoses and targeted therapies. This review comprehensively examines various US- and CT-guided techniques for managing hip pain, including anesthetic and corticosteroid injections for pain relief and inflammation reduction, viscosupplementation for joint lubrication and cartilage health, and platelet-rich plasma therapy for tissue regeneration and healing. The review also details the relevant anatomy of key structures frequently implicated in hip pain, encompassing periarticular structures, bursae (such as the iliopsoas, greater trochanteric, and ischiogluteal bursae), nerves (including the ilioinguinal and lateral femoral cutaneous nerves), and muscles (such as the piriformis and quadratus femoris). By mastering these advanced techniques and acquiring a thorough understanding of the relevant anatomy, interventional radiologists can play a pivotal role in optimizing the evaluation and management of hip pain, offering patients more precise diagnoses and less invasive treatment options, ultimately leading to improved patient outcomes and reduced healthcare costs.