Greater Trochanteric Bursa Injection with Ultrasound

Abstract

Greater trochanteric pain syndrome encompasses several syndromes related to lateral hip and buttock pain. Causes include gluteus minimus and/or medius tendinitis at the insertion site on the greater trochanter, iliotibial band pain, or bursitis. Pain upon palpation of the greater trochanter helps differentiate these pain generators from primary hip pathologies that cause pain that radiates toward the groin (Le and Shah, StatPearls. StatPearls Publishing, Treasure Island, 2022).

Trochanteric bursitis can be caused by injury, overuse, or inflammation due to tendinopathy of the gluteus medius or minimus tendons. Conservative treatments include physical therapy, acetaminophen, and nonsteroidal anti-inflammatories. Greater trochanteric bursa injections are offered as an alternative treatment to patients who have failed conservative therapy or for whom the disease is particularly disabling. Greater trochanteric bursa injections have been successfully performed using anatomical landmarks and fluoroscopy; however, this chapter will highlight the ultrasound-guided approach due to its safety and accuracy.

Greater trochanteric bursa injections are safe and complications are rare but can include septic arthritis, bleeding, allergic reaction, focal fat necrosis, and intra-tendon injection (Reid, J Orthop 13(1):15–28, 2016).