Fluoroscopy-Guided Intra-Articular Hip Corticosteroid Injections: Diagnostic and Therapeutic Utility, Technique, and Steroid Selection

Purpose of Review Intra-articular hip corticosteroid injection is a practical option for selected patients with hip pain, particularly osteoarthritis, and may also clarify whether symptoms arise from the hip rather than the lumbar spine or periarticular structures. This review evaluates the diagnostic and therapeutic utility of injections performed under fluoroscopy, summarizes technique, and discusses steroid selection and dosing. Recent Findings Randomized trials and contemporary syntheses support clinically meaningful short-term improvement in pain and function after image-guided hip corticosteroid injection, although durability is variable and repeated-injection data remain limited. Fluoroscopy provides continuous visualization of osseous landmarks and contrast-confirmed intra-articular spread. Ultrasound avoids radiation and may be more convenient depending on physician comfort level and ultrasound skills. Safety discussions have emphasized transient systemic effects, uncertain associations with rapidly progressive osteoarthritis, and the timing of injection before arthroplasty. Summary Fluoroscopy-guided injection remains a reliable, reproducible diagnostic and therapeutic tool when the pain generator is uncertain or short-term symptom control may facilitate rehabilitation, bridge care, or support shared surgical decision-making. Benefit depends on careful patient selection, technically confirmed intra-articular delivery, conservative dosing, and explicit counseling that relief is usually temporary and that structural disease is not reversed.