ABSTRACT
Progressively destructive hip arthritis is a common complication of patients with ankylosing spondylitis. Palliative intra-articular corticosteroid hip injections are helpful in younger patients who wish to delay joint replacement surgery. Non-contrast computed tomography (CT)-guided intra-articular procedures can potentially minimize radiation exposure compared to fluoroscopy-guided techniques. We describe a CT-guided technique for intra-articular corticosteroid hip injections for severe bilateral hip arthritis which avoids the use of radiologic contrast by documenting the presence of a pre-injection air bubble underneath the fibrous capsule. Significant reduction in symptoms within 48 hours and at 6 weeks post-injection confirmed the successful outcome of this technique.
Subject(s)
Adrenal Cortex Hormones/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Injections, Intra-Articular/methods , Spondylitis, Ankylosing/drug therapy , Adult , Hip , Humans , Male , Steroids , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Biopsy, Needle , Lymphocytes/pathology , Lymphoma, Non-Hodgkin/pathology , Aged , Cytoplasm/pathology , Humans , Male , Tomography, X-Ray ComputedABSTRACT
A new computed tomographic (CT)-guided biopsy technique is described which employs angling both the CT-gantry and the patient to access lesions considered unapproachable using conventional CT techniques. Angling the gantry and the patient, or dual angulation, was applied in five patients with masses located in the pelvis and retroperitoneum that were not easily accessible using gantry angling or patient tilting alone. In each case, the needle tip was demonstrated in the lesion and diagnostic tissue was retrieved. No complications were recorded. A dual-angled approach defines a safe path to a mass and allows obtaining a CT image in the plane of the biopsy needle.
