Hyaluronic acid (HA) is increasingly used by musculoskeletal radiologists in the treatment of osteoarthritis (OA). Although the evidence base for its efficacy is controversial, it remains in common use. With initial evidence suggesting its efficacy in the knee, it is now offered for treating OA of the hip, ankle, and elsewhere.
HA is available in a wide variety of preparations, which may vary in concentration and chemical composition. Clinicians offering intraarticular HA injection should be familiar with the common preparations available and the principal differences between them, its mechanism of action, and the profile of adverse effects associated with its use.