SRP 060 Hip Joint Injections under imaging guidance

Policy number: SRP 060
Policy name: Hip Joint Injections under imaging guidance
Status: Individual Funding Approval
Effective date: 1 April 2024
Next review date: 1 April 2026

Mid and South Essex ICB commissions Hip Joint Injections under imaging guidance on a restricted basis.

A guided hip injection involves injecting a small quantity of local anaesthetic and anti-inflammatory steroid into your hip joint. The procedure is performed in the operating theatre using an X-ray machine to guide the needle.

MSE ICB only fund guided hip joint injections in the following circumstances:

Diagnostic aid
To introduce contrast medium to the joint as part of hip arthrogram
Investigation of infection in biological and replaced hips
Adults with inflammatory arthropathy

Individual prior approval is required.

Funding for patients not meeting the above criteria will only be granted in clinically exceptional circumstances.

Individual funding requests should only be made where the patient demonstrates clinical exceptionality.

Find out more information on applying for funding in exceptional clinical circumstances

Rationale:

There was no evidence showing that imaging is beneficial for diagnosing osteoarthritis. Imaging adds little value, and that osteoarthritis can be diagnosed by taking a thorough history and doing an examination. Imaging can be useful if atypical features are present that could suggest an alternative or additional diagnosis, such as other inflammatory forms of arthritis (for example, rheumatoid arthritis) and malignancy.

Evidence showed that corticosteroid injections had inconsistent benefits on improving quality of life and physical function for people with hip osteoarthritis and reducing pain for people with knee osteoarthritis. There was no evidence showing long-term benefit beyond 3 months.