title: Ultrasound-guided corticosteroid injections for treatment of greater trochanteric pain syndrome: greater trochanter bursa versus subgluteus medius bursa.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of corticosteroid injections into the greater trochanteric bursa as opposed to the subgluteus medius bursa in patients with greater trochanteric pain syndrome.
  
  
  METHODS
  We retrospectively reviewed 183 injections (149 performed in women, 34 performed in men; age range 23-90 years; median, 53 years) performed for treatment of greater trochanteric pain syndrome. A 10-cm visual analog scale survey was used to assess pain level before the procedure and 14 days after the procedure. A 3-mL corticosteroid solution was injected into either the greater trochanteric bursa or the subgluteus medius bursa under direct ultrasound guidance. Procedure images were retrospectively reviewed to determine the site of injection. Diagnostic images obtained at the time of the procedure were also reviewed for findings of tendinopathy, bursitis, and enthesopathy. Statistical analysis of differences in pain reduction was performed, as was analysis for association between pain relief and demographic variables of age, sex, previous injections, and ultrasound findings.
  
  
  RESULTS
  Sixty-five injections met the inclusion criteria; 56 performed in women and nine performed in men (age range, 30-82 years; median, 53 years). Forty-one injections were into the greater trochanteric bursa and 24 into the subgluteus medius bursa. There was a statistically significant difference in pain reduction between greater trochanteric bursa and subgluteus medius bursa injections with a median pain reduction of 3 as opposed to 0 (p < 0.01). There was no statistically significant association between pain relief and demographic variables or ultrasound findings.
  
  
  CONCLUSIONS
  Corticosteroid injections into the greater trochanteric bursa may be more effective than injections into the subgluteus medius bursa for treatment of greater trochanteric pain syndrome.
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. jmcevoy@radiax.com
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: McEvoy
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Lee
authors.forename: Donna G
authors.initials: DG
authors.lastname: Blankenbaker
authors.forename: Alejandro Munoz
authors.initials: AM
authors.lastname: del Rio
authors.forename: James S
authors.initials: JS
authors.lastname: Keene
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002061:Bursa, Synovial; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional
chemical_list: D000305:Adrenal Cortex Hormones