Abstract
This study aimed at investigating the diagnostic value of a local anaesthetic hip injection test to differentiate between hip and spinal pain in patients presenting with concurrent hip and spine pathology. Prospective clinical series. Forty-eight consecutive patients with a diagnostic dilemma of concurrent pathology under the care of one spinal surgeon in one centre were evaluated. The hip injection test involved an intra-articular injection of 0.5% Bupivacaine under fluoroscopic control. Positive response was defined as significant (>70%) or complete relief of pain. A minimal relief (<30%) or no relief of pain was considered a negative response to the injection. Thirty-seven patients reported a positive response to the injection. Of these, 33 (89%) underwent successful hip replacement with complete relief of symptoms. One patient had an unsuccessful hip replacement. Three patients with a positive response declined surgery. Eleven patients had a negative response to the test. Ten of them responded satisfactorily to treatment directed towards their spinal pathology and one patient had a successful hip replacement. The sensitivity of the test was 97% and specificity 91%. There was no complication to the injection in any patient. Local anaesthetic hip injection test is a safe and reliable diagnostic tool in identifying the source of pain in patients with combination of hip and spinal pathology.
Published Version
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