Hip Impingement Treatment London | Private Ultrasound Diagnosis & Injections

Hip Impingement (Femoro-Acetabular Impingement) Explained

Anatomy of the Femoral Head & Neck

Hip impingement syndrome (femoro-acetabular impingement) is a condition that is separate from degenerative age-related arthritis of the hip joint.

It is caused by bony changes at the periphery of either the acetabular socket (acetabulum) or the femoral neck.

Hip Impingement Symptoms

Physical examination often demonstrates pain during hip flexion and internal rotation, which approximate the acetabular socket and femoral neck.

Patients often report that symptoms are aggravated by:

• Rotational movements

• Sports involving deep hip flexion (such as cycling)

• Sitting for prolonged periods, due to the anatomical compression caused by these positions

Hip Impingement Causes

As we flex and rotate the hip, the femoral neck and the acetabular socket move closer together.

If there is a bony irregularity along the margins of either the acetabular socket or the femoral neck, these structures may impinge on one another during movement, resulting in compression and pain with hip flexion and rotation.

Hip Impingement Diagnosis

An ultrasound scan, along with X-rays, are typically the initial forms of imaging used to assess for femoro-acetabular impingement.

These modalities can help establish:

• The cortical bony outline of the femoral neck

• Any bony irregularities or signs of arthritis at the hip joint margins

Ultrasound can also evaluate:

• The presence of fluid-filled bursae or effusions

• Changes in the psoas tendon, which overlies the hip and may contribute to similar symptoms

Ultrasound Guided Injections for Hip Impingement Syndrome

How is an Injection Administered for Hip Impingement ?

When symptoms are present, the patient’s goals and the severity of symptoms will help guide management.

In many cases, physical therapy exercises can help to alleviate symptoms, particularly if ergonomic factors contributing to impingement are addressed.

For patients with persistent symptoms, an ultrasound-guided injection can be considered. In cases of hip impingement, this often involves the use of hyaluronic acid (a gel-like buffer) injected into the affected region to help reduce discomfort and improve joint mobility.

What to Do After Your Femoral Neck Hip Joint Ultrasound Guided Injection

Needle Path & Post-Injection Pain
Many patients feel apprehensive before a hip joint injection, but the procedure is performed calmly under local anaesthetic to minimise discomfort. The hip joint is deep, but with precise ultrasound guidance, the needle path itself typically does not cause significant post-injection pain once the local anaesthetic has worn off.

Very rarely, a post-injection flare may occur, causing temporary pain for 2–3 days. This is believed to be related to the medication reacting with the joint fluid, rather than the needle path itself.

Wound Care & Infection Risk
As with all ultrasound-guided injections, avoid exposing the injection site to dirty or public water (such as swimming pools or hot tubs) for 2–3 days due to the small risk of infection. Monitor the injection site for redness, swelling, or discharge and contact me if these occur.

Activity Guidance
Activity should be kept light for the first 1–2 weeks following the injection and as best as possible avoid prolonged sitting. After this period, if symptoms allow, you can begin to increase your activity levels and gradually return to normal daily tasks and rehabilitation exercises as directed.

Follow-Up
If you experience unusual pain, swelling, redness, or any concerns following your injection, please contact me immediately.

Other Treatments for Hip Impingement

Mobility Exercises for Hip Impingement

Rotational Control Exercises for Hip Impingement

Strengthening Exercises for Hip Impingement

Hip Impingement | Evidence base

The evidence base for the management of femoroacetabular impingement is still developing, as it is a relatively recent diagnostic category. Early studies and clinical guidelines support the use of physiotherapy to address flexibility, strength, and neuromuscular control, and some patients show good symptomatic improvement without surgery. However, large randomized trials (such as UK FASHIoN) suggest that arthroscopic surgery may result in better pain and functional outcomes in selected patients, particularly younger, active individuals with significant morphological abnormalities. Despite this, conservative management remains a valid initial approach, especially when symptoms are mild or activity modifications are effective.

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