Correct needle position (a). Contrast media injection before steroid infiltration to prove extravascular needle position (b).
Indication: Unexplained and persistent hip pain, sometimes after total hip replacement

Target: Obturator nerve, just below the superior pubic ramus at the posterior aspect of the obturator foramen, medial to the acetabulum

Procedure:

  • - Patient in supine position
  • - Axial scan centred on the obturator foramen
  • - Anterior approach
  • - CT fluoroscopy-guided direct puncture from skin to target (posterior aspect of obturator foramen) with a 22 gauge needle
  • - Infiltration of 5 mL of lignocaine (Block infiltration) and steroid for long acting pain sedation

Danger: Easy procedure, without any particular risk