Asked by Anonymous
There are 3 different approaches to hip arthrocentesis:
1. Lateral approach: Insert the needle at a 45-degree angle with the surface of the thigh just inferior and anterior to the greater trochanter. Advance the needle medially and proximally close to the bone for 5 to 10 cm, depending on the size of the patient, and into the joint.
2. Anterior approach: Palpate the femoral artery in line with the inguinal ligament. Insert the needle 2.5 cm lateral and 2.5 cm distal to this point at a 45-degree angle to the skin surface. Advance the needle 5 to 7.5 cm medially and proximally into the joint.
3. Medial approach: Flex and abduct the leg; this is usually a more comfortable position for patients with septic arthritis. Place the needle inferior to the adductor longus tendon and using image intensification advance it in a plane below the palpated femoral artery until the femoral head or neck is reached. Aspirate the joint.
Reference: Capmbell's Operative Orthopedics - 14th Edition
