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Methods: The study comprised cadaver dissections with needles in place; simulated live ultrasound OSCE marking of planned needle trajectories with Doppler activated to locate LCFA signals; and a survey of musculoskeletal ultrasound–certified rheumatologists. Results: Direct LCFA contact occurred in one cadaver dissection. In OSCE cases, 22% of trajectories traversed LCFA Doppler signals, with mean minimal distance 4 mm (0–11). Surveyed clinicians reported nonroutine Doppler use. Conclusion: LCFA injury risk exists and routine Doppler use should be considered in standard protocols.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-vascular-obstacle-in-ultrasound-guided-hip-joint-injection/317041/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-vascular-obstacle-in-ultrasound-guided-hip-joint-injection/317041.png","ImageObject",300,407,{"name":92,"@type":93},"Cipher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What vascular structure is the study focused on during ultrasound-guided hip injections?","Question",{"text":113,"@type":114},"The study focuses on the lateral circumflex femoral artery (LCFA) and evaluates the risk of injury during ultrasound-guided intra-articular hip joint injection.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were Doppler and needle trajectory relationships assessed?",{"text":118,"@type":114},"In the simulated OSCE component, rheumatologists marked planned needle trajectories on live ultrasound images, then Doppler was activated to locate the LCFA, and the distance between the trajectory and arterial signal was recorded.",{"name":120,"@type":111,"acceptedAnswer":121},"What were the key findings regarding LCFA contact and proximity?",{"text":122,"@type":114},"Direct LCFA contact occurred in one of four cadaver dissections. In OSCE simulations, trajectories passed through LCFA Doppler signal in 22% of cases, with a mean minimal distance of 4 mm (range 0–11 mm).",{"name":124,"@type":111,"acceptedAnswer":125},"What practice does the study recommend regarding Doppler use?",{"text":126,"@type":114},"Routine use of Doppler should be considered in standard ultrasound-guided hip injection protocols to help identify and avoid the LCFA.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},317041,1790225542,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":52},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","| Original Article |\n| --- |\n|  |\n\nA Vascular Obstacle in Ultrasound‑Guided Hip Joint Injection  \nMaryAnn Zhang1, Monica A. Pessina2, Jay B. Higgs3, Eugene Y. Kissin1*  \n1Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA, 2Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts, USA, 3Brooke Army Medical Center, San Antonio, Texas, USA  \nAbstract  \nBackground: We evaluated the risk of lateral circumflex femoral artery (LCFA) injury during ultrasound-guided intra-articular hip injections. Methods: This study was divided into three parts. (1) Four ultrasound-guided hip injections were performed on human cadavers. With needles in place, tissues were dissected to expose the LCFA. (2) Ultrasound-trained rheumatologists marked a planned needle trajectory from skin to hip joint on live human ultrasound images during an Observed Structured Clinical Examination (OSCE). Doppler was subsequently activated to locate the LCFA, and the distance between trajectory and arterial signal was recorded. (3) Rheumatologists certified in musculoskeletal ultrasound were surveyed about joint injection vascular complications. Results: (1) In one of the four cadaveric dissections, the needle made direct contact with the LCFA. (2) Of 27 OSCE participants, only two activated Doppler before marking simulated hip injection trajectories. Trajectories passed through LCFA Doppler signal in six (22%) cases. Mean minimal distance from trajectory to arterial signal was 4 mm (range, 0–11 mm) . (3) Of 62 survey respondents, 24% stated that they did not use Doppler routinely. While none reported bleeding injuries with their patients, 16% knew of a hip injection-related vascular complication performed by another provider. Conclusion: There is a risk of LCFA injury during ultrasound-guided hip joint injection. Routine use of Doppler should be considered in standard hip injection protocols.  \nKeywords: Diagnostic imaging, hip, intra-articular injections, radiology, ultrasonography  \nintroduCtion  \nUltrasound has become an increasingly utilized imaging tool for hip joint evaluation and therapeutic intervention.[1] Numerous studies have described the ease of ultrasound-guided hip joint injection for routine musculoskeletal procedures ranging from intra-articular corticosteroid tohyaluronic acid administration.[2-4] With proper technical training, it has been shown to be just as accurate as fluoroscopic-guided hip injection.[5,6] This noninvasive imaging modality eliminates the need for radiation and, as a result, can be easily accessed in the office setting.[7]  \nMost of the prior literatures advocating this sonographic technique for the hip joint describe an anterior approach where the needle is inserted lateralto the femoral neurovascular bundle.[7-12] Increased risk of vascular puncture during hip procedures (i.e., femoral nerve blockade) is a major concern. Injury of the lateral circumflex femoral artery (LCFA) is a proposed cause of bleeding in such procedures.[13] The LCFA, a branch of the profundafemoris artery, courses laterally in the femoral triangle in close proximity to the acetabulofemoral joint, with its three branches  \nReceived: 12-04-2017 Accepted: 05-06-2017 Available Online: 12-06-2018  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[www.jmuonline.org](www.jmuonline.org) |\n|  | DOI:\u003Cbr>10.4103/JMU.JMU_8_ 17 |\n\nsupplying the surrounding gluteal muscles and hip joint.[14] While various articles and textbooks on ultrasound-guided hip joint injection have advocated the use of Doppler imaging to avoid the femoral vascular bundle, to our knowledge, only one study[8] has cited the LCFA.[7-12,15-20] None recommend the routine use of Doppler for identifying and avoiding the LCFA. Studying the anatomy oftheLCFA during intra-articular hip injections would provide abetter understanding of vascular obstacles and promote safer inject","cbCaitkiYk0mxH67","https://ap.wps.com/l/cbCaitkiYk0mxH67","pdf",689749,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n# Methods\n## Study Design and Ethics\n## Joint Injections in Human Cadavers","[{\"question\":\"What vascular structure is the study focused on during ultrasound-guided hip injections?\",\"answer\":\"The study focuses on the lateral circumflex femoral artery (LCFA) and evaluates the risk of injury during ultrasound-guided intra-articular hip joint injection.\"},{\"question\":\"How were Doppler and needle trajectory relationships assessed?\",\"answer\":\"In the simulated OSCE component, rheumatologists marked planned needle trajectories on live ultrasound images, then Doppler was activated to locate the LCFA, and the distance between the trajectory and arterial signal was recorded.\"},{\"question\":\"What were the key findings regarding LCFA contact and proximity?\",\"answer\":\"Direct LCFA contact occurred in one of four cadaver dissections. In OSCE simulations, trajectories passed through LCFA Doppler signal in 22% of cases, with a mean minimal distance of 4 mm (range 0–11 mm).\"},{\"question\":\"What practice does the study recommend regarding Doppler use?\",\"answer\":\"Routine use of Doppler should be considered in standard ultrasound-guided hip injection protocols to help identify and avoid the LCFA.\"}]","A Vascular Obstacle in Ultrasound-Guided Hip Joint Injection | PDF",1789928145]