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Fewer admissions with Hip POCUS

May 30, 2015

The Canadian healthcare system is perfect, eh? Uh, no not really.

One of the more well-publicized and frustrating ways in which this imperfection manifests itself is the wait list for orthopedic consultation and elective surgery, the most notorious being joint replacement. All Canadian EDs probably see patients with some frequency who present with osteoarthritis of the knee or hip that has become so severe that they are no longer able to walk. In some cases, these patients are admitted to hospital, which is really too bad given that the admission could have clearly been avoided.

POCUS to the rescue!

I’ve seen 2 patients with osteoarthritis of the hip in the last year who presented with this exact scenario. Faced with probable admission, as a last ditch effort, I decided to use POCUS to guide injection of local anesthetic and steroids into their hip joint. Miraculous relief of their pain! One of them even found out when I was working and came back to see me again for another injection a few months later. And in case you’re curious, no, I had never injected a hip with steroids or anything else prior to POCUS. But POCUS makes the procedure almost idiot-proof. Which in my case, is a good thing!

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