The anterior hip capsular recess is the synovial extension of the hip joint anteriorly between the femoral neck and the iliopsoas, visible on ultrasound as a small fluid-containing space. It is the primary site for ultrasound-guided hip joint injection and aspiration.
The anterior hip recess is the standard ultrasound target for hip joint injection, aspirated with the needle directed between the femoral head and the anterior capsule. Hip effusion fills this recess and is measured as the distance between the anterior femoral neck cortex and the echogenic capsule. Greater than 7 mm or 2 mm difference from the contralateral side indicates significant effusion. Septic hip arthritis, transient synovitis, and hip OA all produce anterior recess distension.
Synovial fluid accumulation in the anterior hip recess from septic arthritis, transient synovitis, or osteoarthritis, measured on ultrasound as anterior recess distension and aspirated to distinguish infective from non-infective causes.
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