Ultrasound-Guided Steroid Infiltration in the Treatment of Greater Trochanter Syndrome

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.