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2022, Number 1

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Invest Medicoquir 2022; 14 (1)

Ultrasound-guided steroid infiltration in the treatment of greater trochanter syndrome

Benítez NPP, Torriente OD, Soria RA, Gutiérrez PM
Full text How to cite this article

Language: Spanish
References: 23
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Key words:

greater trochanter syndrome, steroid infiltration, ultrasound, anatomical landmarks.

ABSTRACT

Introduction. The greater trochanter syndrome is characterized by pain in the lateral aspect of the hip, the frequency in the general population ranges between 10% and 20% and it is more frequent in the female sex. Steroid infiltration in the trochanteric area is the most widely used treatment; the imaging guide has been used for its administration, although some studies consider it unnecessary. Methods. In order to evaluate the usefulness of the use of the imaging guide in the treatment with steroid infiltration in the greater trochanter syndrome, a therapeutic clinical trial was carried out in 100 patients with a diagnosis of greater trochanter syndrome who attended the Pain Clinic from the Surgical Medical Research Center in the period from December 2016 to December 2020; the patients were randomized into two study groups, A and B. Group A received treatment with steroid infiltration using ultrasound as a guide; in group B, the treatment was carried out taking the anatomical landmarks as a guide. Clinical improvement was evaluated according to the values of the visual analogue scale and the Latinen test. The adverse events recorded in each procedure were also evaluated. The group with a greater number of patients in whom a visual analog scale of less than 2 and a Latinen test of less than 4 coincided in the fourth week of treatment was considered more effective. Results. Group A obtained a greater number of patients in whom a value of the visual analog scale of less than 2 and a Latinen test of less than 4 coincided (p <0.001); furthermore, fewer adverse events occurred in this group (p <0.001). Conclusions. Ultrasound-guided steroid injection was more effective and safer than landmark-guided steroid injection.


REFERENCES

  1. Leonard M.H. Trochanteric syndrome; calcareous and no calcareous tendonitis and bursitis about the trochanter major. J Am Med Assoc. 1958; 168:175–17

  2. Segal NA, Felson DT, Torner JC, Zhu Y, Curtis JR, Niu J. Multicenter Osteoarthritis Study Group Greater trochanteric pain syndrome: epidemiology and associated factors.Arch Phys Med Rehabil .2007; 88:988–992

  3. Nissen J. M., Brulhart L., Faundez A, Finckh A. Courvoisier D., Genevay S.Glucocorticoid injections for greater trochanteric pain syndrome: Clinical a randomised double-blind placebo-controlled (GLUTEAL. trial. Rheumatology. 2018; https://doi.org/10.1007/s10067-018-4309-6

  4. Lequesne M, Mathieu P, Vuillemin-Bodaghi V, Bard H, Djian P Gluteal tendinopathy in refractory greater trochanter pain syndrome: diagnostic value of two clinical tests. Arthritis Rheum. 2008; 59:241–246

  5. Bird PA, Oakley SP, Shnier R, Kirkham BW. Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome.Arthritis Rheum. 2001;44(9. :2138–45.

  6. Segal NA, Harvey W, Felson DT, Yang M, Torner JC, Torner JC,Nevitt MC. Multicenter Osteoarthritis Study Group. Leg-length inequality is not associated with greater trochanteric pain syndrome.Arthritis Res Ther. 2008;10(3. :R62.

  7. Franceschi F, Papalia R, Paciotti M, Franceschetti E, Di Martino A, Maffulli N, Denaro V. Obesity as a risk factor for tendinopathy: systematic review. Int J Endocrinol. 2014;670262.

  8. Fearon AM, Cook JL, Scarvell JM, Neeman T, Cormick W, Smith PN Greater trochanteric pain syndrome negatively affects work, physical activity and quality of life: a case control study. JArthroplast. 2014; 29:383–386

  9. Tibor LM, Sekiya JK Differential diagnosis of pain around the hip joint.Arthroscopy. 2008;24: 1407-14021.

  10. Kong A, Van der Vliet A, Zadow S MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Eur Radiol. 2017; 17: 1772-1783.

  11. McMahon S, Smith T.O, Hing C. Systematic Review of Imaging Modalities in the Diagnosis of Greater Trochanteric Pain Syndrome Musculoskelet. Care 10.2012 232–239

  12. Cvitanic O, Henzie G, Skezas N, Lyons J, Minter J MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus. . American Journal of Roentgenology .2004,182: 137–43.

  13. Lequesne M, Dijan P, Vuillemin V Prospective study of refractory greater trochanter pain syndrome.MRI findings of gluteal tendon tears seen at surgery. Clinical and MRI results of tendon repair. Joint, Bone, Spine .2008;75: 458–64.

  14. A. Frizziero et al. Conservative management of tendinopathies. Review article. Muscles, Ligaments and Tendons Journal. 2016;6 (3. :281-292

  15. . Mitchell W. G et al. Outcomes and cost-effectiveness of ultrasound-guided injection of the trochanteric bursa. Rheumatology International .2018; 38:393–401 https://doi.org/10.1007/s00296-018-3938-z

  16. Lievense A, Bierma-Zeinstra S, Schouten B, Bohnen A, Verhaar J, Koes B. Prognosis of trochanteric pain in primary care. Br JGen Pract. 2005; 55:199–204.

  17. Ege Rasmussen KJKJ, Fan NKJ Trochanteric bursitis. Treatment by corticosteroid injection. Scand J Rheumatol. 1985; 14:417–420

  18. Rompe JD, Segal NA, Cacchio A, Furia JP, Morral A, Maffulli N Home training, local corticosteroid injection, or radial shock wave therapy for greater trochanter pain syndrome. Am J SportsMed. 2009; 37:1981–1990

  19. Karpinski MR, Piggott H. Greater trochanteric pain syndrome. A report of 15 cases. J Bone Joint Surg Br. 1985;67(5. :762–3.

  20. Shanthanna et al. Local anesthetic injections with or without steroid for chronic non-cancer pain: aprotocol for a systematic review and metaanalysis of randomized controlled trials. Systematic Reviews. 2016; 5:18DOI 10.1186/s13643-016-0190-z

  21. Cohen SP, Strassels SA, Foster L, et al. Comparison of fluoroscopically guided and blind corticosteroid injections for greater trochanteric pain syndrome: multicentre randomised controlled trial. BMJ. 2019;338: b1088

  22. Brinks A, van Rijn RM, Willemsen SP, Bohnen AM, Verhaar JA, Koes BW, Bierma-Zeinstra SM. Corticosteroid injections for greater trochanteric pain syndrome: A randomized controlled trial in primary care. Ann Fam Med. 2011;9(3. :226–34.

  23. Dean BJ, Lostis E, Oakley T, Rombach I, Morrey ME, Carr AJ The risks and benefits of glucocorticoid treatment for tendinopathy: a systematic review of the effects of local glucocorticoid on tendon. Semin. Arthritis Rheum. 2014; 43:570–576.




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Invest Medicoquir. 2022;14