title: Landmark-Guided and Ultrasound-Guided Approaches for Trochanteric Bursa Injection: A Cadaveric Study.
abstract: Trochanteric bursa (TB) injection with local anesthetic and corticosteroid is a treatment for patients suffering from greater trochanteric pain syndrome. Both landmark (LM)-guided and ultrasound (US)-guided methods have been used, but their accuracies have not been determined. This study examined the accuracy of these injections with cadaveric dissection.
  
  
  
  Twenty-four hip specimens were randomized to receive TB injections with methylene blue under either LM-guided or US-guided approach. After dissection, the locations of the dye were classified into 3 categories: intrabursal, extrabursal, or combined intrabursal and extrabursal. The presence of dye in the intrabursal space with or without extrabursal leak was considered a successful injection. Accuracy was defined as the percentage of successful injection.
  
  
  
  The accuracies of the LM-guided and US-guided injection were 0.67 (95% confidence interval 0.35-0.90) and 0.92 (95% confidence interval 0.62-1.00), respectively, with no significant difference.
  
  
  
  This is the first cadaveric study examining the accuracy of both the US-guided and LM-guided techniques for TB injection. Future clinical studies are required to compare the outcomes of LM-guided and US-guided greater trochanteric pain syndrome injection.
authors.affiliation: From the *Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, Ontario, Canada; and †Department of Anatomy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Mu
authors.forename: Philip
authors.initials: P
authors.lastname: Peng
authors.forename: Anne
authors.initials: A
authors.lastname: Agur
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging*; D002061:Bursa, Synovial / Q000000981:diagnostic imaging* / Q000378:metabolism; D002102:Cadaver; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging* / Q000378:metabolism; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D007270:Injections, Intra-Articular / Q000379:methods; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage / Q000378:metabolism; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D008751:Methylene Blue