Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Hip steroid injections associated with bone changes

29.11.2017

Osteoarthritis patients who received a steroid injection in the hip had a significantly greater incidence of bone death and collapse compared with control groups, according to new research presented today at the annual meeting of the Radiological Society of North America (RSNA).

Receiving an injection of a steroid and anesthetic is a common treatment for patients who are experiencing pain and inflammation in a joint, such as the hip, knee or shoulder.


A 58-year-old woman with left hip pain. X-ray from one month prior to the steroid/anesthetic injection demonstrates moderate joint space narrowing (arrows) and bony proliferation (arrowheads).

Credit: Radiological Society of North America


X-rays three months after the steroid/anesthetic injection demonstrate complete loss of joint space (arrows), sclerosis of the femoral head (*), and flattening of femoral head articular surface consistent with collapse (arrowheads).

Credit: Radiological Society of North America

"Changes due to osteoarthritis, such as narrowing in the space between joints and the development of bony proliferations, typically develop slowly over time," said Connie Y. Chang, M.D., radiologist at Massachusetts General Hospital and assistant professor of radiology at Harvard Medical School in Boston. "When reading follow-up radiographs of patients who had received a hip injection, we noticed changes had developed rapidly in some patients."

To determine whether arthritis worsened in patients following a hip steroid/anesthetic injection, Chang and a team of radiologists specializing in musculoskeletal diagnostic imaging and intervention, including hip injections, conducted a study involving 102 patients (age range 19-92, including 62 women) who received X-ray images of the treated hip at the time of the injection and during a follow-up three to nine months later.

Two musculoskeletal radiologists independently reviewed the X-ray images of the patients who received the injections and those of two control groups matched to demographics and follow-up imaging duration. The control groups consisted of 102 patients who had hip X-rays without steroid/anesthetic injection and 44 patients who underwent imaging and a steroid/anesthetic injection in the shoulder.

The radiologists reported new osteonecrosis in 22-24 percent of hip injection patients, compared to 5-9 percent in the hip control group and 5 percent in the shoulder injection control group. They observed bone collapse in the head of the femur bone, located at the top of the femur at the articulation with the pelvic bone, in 15-17 percent of hip injection patients, versus 4 percent of hip control patients and 2 percent of shoulder control patients.

Hip injection patients also showed increased imaging findings of osteoarthritis compared to the control groups, but the differences were not statistically significant.

Dr. Chang noted that patients receiving hip injections have symptoms of hip pain severe enough to require the injection and may be prone to faster progression of bony changes compared to the control groups. These considerations may be important as some orthopedists are requesting higher steroid doses and injections in younger patients.

"We need to look at what's going on with the steroid/anesthetic injectate and osteoarthritis patients to determine what's causing the changes that occur in some patients," Dr. Chang said. "However, we don't want to deter patients from getting an injection. These results are enough to warrant an investigation, but not enough to cancel a procedure."

###

Co-authors are F. Joseph Simeone, M.D., Joao Rafael T. Vicentini, M.D., and Susan V. Kattapuram, M.D.

Note: Copies of RSNA 2017 news releases and electronic images will be available online at RSNA.org/press17 beginning Monday, Nov. 27.

RSNA is an association of over 54,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on musculoskeletal X-rays, visit RadiologyInfo.org.

Media Contact

Linda Brooks
lbrooks@rsna.org
630-590-7762

 @rsna

http://www.rsna.org 

Linda Brooks | EurekAlert!

More articles from Health and Medicine:

nachricht Microgel powder fights infection and helps wounds heal
14.11.2018 | Michigan Technological University

nachricht Spread of deadly eye cancer halted in cells and animals
13.11.2018 | Johns Hopkins Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

Im Focus: Research icebreaker Polarstern begins the Antarctic season

What does it look like below the ice shelf of the calved massive iceberg A68?

On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.

Im Focus: Penn engineers develop ultrathin, ultralight 'nanocardboard'

When choosing materials to make something, trade-offs need to be made between a host of properties, such as thickness, stiffness and weight. Depending on the application in question, finding just the right balance is the difference between success and failure

Now, a team of Penn Engineers has demonstrated a new material they call "nanocardboard," an ultrathin equivalent of corrugated paper cardboard. A square...

Im Focus: Coping with errors in the quantum age

Physicists at ETH Zurich demonstrate how errors that occur during the manipulation of quantum system can be monitored and corrected on the fly

The field of quantum computation has seen tremendous progress in recent years. Bit by bit, quantum devices start to challenge conventional computers, at least...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

European Space Talks: Weltraumschrott – eine Gefahr für die Gesellschaft?

23.10.2018 | Event News

 
Latest News

Putting food-safety detection in the hands of consumers

15.11.2018 | Information Technology

Insect Antibiotic Provides New Way to Eliminate Bacteria

15.11.2018 | Life Sciences

New findings help to better calculate the oceans’ contribution to climate regulation

15.11.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>