Impact of fluoroscopic injection location on immediate and delayed pain relief in patients with greater trochanteric pain syndrome

Mao, Lisa J; Crudup, John B; Quirk, Cody R.; Patrie, James T.; Nacey, Nicholas C.

doi:10.1007/s00256-020-03451-7

Skeletal Radiol

2020

DOI: 10.1007/s00256-020-03451-7

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Impact of fluoroscopic injection location on immediate and delayed pain relief in patients with greater trochanteric pain syndrome

Lisa J Mao

John B Crudup²,

Cody R. Quirk

et al.

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Cited by 3 publications

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“…One randomized double-blind placebo-controlled trial of peri-tendinous injections of glucocorticoids around the gluteal tendons showed no statistically significant outcome difference compared with normal saline injections [40]. Even though fluoroscopy can be used to successfully inject the trochanteric bursa or subgluteus medius bursa in patients with GTPS [41], in a multicenter randomized controlled trial, fluoroscopically guided injections were not associated with superior clinical outcomes at 1 month compared to palpationguided injections alone [42].…”

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confidence: 99%

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part IV, hip

et al. 2021

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Objectives Image-guided musculoskeletal interventional procedures around the hip are widely used in daily clinical practice. The need for clarity concerning the actual added value of imaging guidance and types of medications to be offered led the Ultrasound and the Interventional Subcommittees of the European Society of Musculoskeletal Radiology (ESSR) to promote, with the support of its Research Committee, a collaborative project to review the published literature on image-guided musculoskeletal interventional procedures in the lower limb in order to derive a list of clinical indications. Methods In this article, we report the results of a Delphi-based consensus of 53 experts who reviewed the published literature for evidence on image-guided interventional procedures offered in the joint and soft tissues around the hip in order of their clinical indications. Results Ten statements concerning image-guided treatment procedures around the hip have been collected by the panel of ESSR experts. Conclusions This work highlighted that there is still low evidence in the existing literature on some of these interventional procedures. Further large prospective randomized trials are essential to better confirm the benefits and objectively clarify the role of imaging to guide musculoskeletal interventional procedures around the hip. Key Points • Expert consensus produced a list of 10 evidence-based statements on clinical indications of image-guided interventional procedures around the hip. • The highest level of evidence was only reached for one statement. • Strong consensus was obtained for all statements.

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confidence: 99%

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part IV, hip

et al. 2021

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Sonographic pathoanatomy of greater trochanteric pain syndrome

Atilano,

Martin,

Iglesias

et al. 2023

J Ultrasound

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What factors influence pain scores following Corticosteroid injection in patients with Greater Trochanteric Pain Syndrome? A systematic review

Foxcroft,

Stephens,

Woodhead

et al. 2024

BMC Musculoskelet Disord

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Background Cortico-Steroid Injections (CSI) are commonly used to treat patients with Greater Trochanteric Pain Syndrome (GTPS) but it is unclear which patients will experience improvements in pain. Objectives To identify factors that influence improvements in pain for patients with GTPS treated with CSI. Design Systematic review. Methods A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline and PEDro databases. Studies were eligible for inclusion if they investigated factors that influenced changes in pain experienced by patients with GTPS who received a CSI. Studies needed to include relevant summary statistics and tests of clinical significance. Risk Of Bias in Non-randomised Trials Of Interventions (ROBINS-I) and Risk Of Bias 2 (ROB2) tools were used to assess bias. Results The search identified 466 studies, 8 were included in the final review with a total of 643 participants. There was no association between demographic variables such as age, sex, symptom duration or obesity and pain outcomes post-CSI. Having a co-existing musculoskeletal (MSK) condition such as knee osteoarthritis or sacroiliac/lumbar spine pain was associated with less pain reduction post-CSI. Injections into the Trochanteric Bursa were associated with longer lasting pain reduction than Gluteus Medius Bursa or extra-bursal injections. Image guidance of CSI maintained lower pain scores at six months but did not increase the duration of the therapeutic effect past six months. The presence of specific ultrasound scan features was not associated with differences in pain scores. Conclusions Patients with co-existing MSK conditions may not respond to CSI as well as those without. Injections into the Greater Trochanteric Bursa may have longer lasting benefit. Further research is needed on the use of USS imaging findings and image guidance.

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Impact of fluoroscopic injection location on immediate and delayed pain relief in patients with greater trochanteric pain syndrome

Cited by 3 publications

References 21 publications

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part IV, hip

Clinical indications for image-guided interventional procedures in the musculoskeletal system: a Delphi-based consensus paper from the European Society of Musculoskeletal Radiology (ESSR)—part IV, hip

Sonographic pathoanatomy of greater trochanteric pain syndrome

What factors influence pain scores following Corticosteroid injection in patients with Greater Trochanteric Pain Syndrome? A systematic review

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