title: Calcific trochanteric bursitis: resolution of calcifications and clinical remission with non-invasive treatment. A case report.
abstract: Calcific trochanteric bursitis, a common regional pain syndrome, is characterized by chronic, intermittent aching pain over the lateral aspect of the hip and limitation of function. Effective treatment is invasive, including infiltration therapy and surgical intervention. The therapeutic effects of conservative treatment modalities have not been proven. A 59-year-old woman presented at the department of physical medicine and rehabilitation with a 2-year history of pain in the right hip. She had been treated with several agents such as glucocorticoids and local anesthetics (via injection) for two years, but without success. Physical examination revealed the clinical diagnosis of bursitis trochanterica. Radiographic findings showed calcified rounded masses measuring about 1.5 cm in diameter around the greater trochanter; a calcific bursitis trochanterica was diagnosed. The patient presented for conservative treatment in order to avoid surgical intervention for removing the calcification and the bursal sac. A non-invasive treatment regimen including intensive pulsed ultrasound therapy, physiotherapy and iontophoresis was started. The conservative treatment led to a remission of both, symptoms as well as radiographic findings, which revealed complete resolution of calcifications. This case report shows that, in cases of calcific trochanteric bursitis (including those with extensive calcifications), a non-invasive conservative treatment regimen including intensive high-dosed pulsed ultrasound therapy should be attempted before more invasive treatment (injections, surgery) is considered.
authors.affiliation: Department of Physical Medicine and Rehabilitation, General Hospital of Vienna, University of Vienna, Austria. richard.crevenna@univie.ac.at
authors.forename: Richard
authors.initials: R
authors.lastname: Crevenna
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kéilani
authors.forename: Günther
authors.initials: G
authors.lastname: Wiesinger
authors.forename: Peter
authors.initials: P
authors.lastname: Nicolakis
authors.forename: Michael
authors.initials: M
authors.lastname: Quittan
authors.forename: Veronika
authors.initials: V
authors.lastname: Fialka-Moser
mesh_terms: D002062:Bursitis / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D007478:Iontophoresis; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011859:Radiography; D016896:Treatment Outcome; D014464:Ultrasonic Therapy