USMSIT/NMUSIT Fundamental Guide on Diagnostic and Interventional Hip Ultrasonography

Abstract

Hip pain arises from a spectrum of intra-articular, periarticular, and neurogenic conditions. Ultrasound offers real-time, radiation-free visualization of the hip joint, adjacent soft tissues, and peripheral nerves – making it an essential tool in contemporary musculoskeletal evaluation. Guided by the EURO-MUSCULUS/USPRM framework, this guideline proposes a standardized, anatomy-based protocol for both diagnostic and interventional hip ultrasonography. Developed under the educational mission of the Ultrasound and Musculoskeletal/Neuromuscular Sonography Initiative in Taiwan – through its USMSIT and NMUSIT programs – the protocol combines structured instruction, live demonstrations, and supervised hands-on training to promote consistency and clinical relevance. The article outlines a comprehensive scanning strategy detailing key anatomical landmarks, recommended patient positioning, and optimal transducer orientation. Representative sonographic findings of common hip disorders – including joint effusion, gluteal tendinopathy, hamstring injuries, piriformis-related pathology, and lateral femoral cutaneous nerve entrapment – are provided to support interpretation. Techniques for ultrasound-guided interventions, such as intra-articular, greater trochanteric, and piriformis injections, are also described. Standardizing image acquisition and interpretation may enhance diagnostic accuracy and support safer as well as more effective management of hip pain.