Purpose or Case Report: This technical innovation describes our institution’s standardized technique for palliative steroid injections in children with symptomatic neuromuscular hip dysplasia. Children with neuromuscular hip dysplasia are at risk for developing painful hip dislocation, which can dramatically affect their quality of life.
Methods & Materials: Patient selection involves considering overall health, symptom severity, and care objectives, with a focus on palliative steroid injections for diagnostic, temporary pain relief, and long-term pain management. The presence of child life specialists during procedures minimizes anxiety, with sedation rarely required. Patient positioning strategies ensure correct intra-articular needle placement while avoiding vascular structures. The procedure involves sterile preparation, local anesthesia, and fluoroscopic guidance. Needle selection is tailored to the patient’s age and size. Triamcinolone acetonide is the preferred glucocorticoid due to its extended duration of action and low systemic absorption. Standardized protocols, including vetting by a dedicated radiology team, contribute to patient safety and procedure success.
Results:
Conclusions: Steroid injections are an appropriate palliative treatment option for painful neuromuscular hip dysplasia. The choice between surgical intervention and serial injections hinges on clinical factors, including comorbidities, GMFCS classification, and femoral head deformity. Early hip reconstruction is the preferred surgical approach, minimizing deformity and enhancing outcomes. For non-reconstructable hips, femoral resection remains the definitive surgical option. Nonetheless, serial steroid injections are an effective non-surgical alternative for non-reconstructable hips. Steroid injections also offer temporary pain relief and diagnostic utility. Caregivers often rely on interpreting nonverbal cues to identify pain in nonverbal patients, making injections a litmus test to confirm the source of pain.

In summary, image-guided steroid injections are a versatile tool in the management of neuromuscular hip pain. These injections are used to identify the source of perceived pain, offer temporary relief while awaiting surgery, and serve as an effective nonoperative strategy. Collaborative efforts involving standardized dosages, needle placement techniques, and safety vetting are paramount when caring for these patients.