II. Indication
III. Efficacy
- Single injection associated with 2.7 fold increase in those pain-free at 5 years
IV. Preparation
- Needle
- Gauge: 22 to 25
- Length: 1.5 inch (3.0 or 3.5 inch spinal needle in larger adults)
- Intraarticular Corticosteroids (choose one)
- Methylprednisolone: 1 ml of 40 mg/ml OR
- Betamethasone (Celestone Soluspan): 1 ml of 6 mg/ml
- Triamcinolone 40 mg
- Dexamethasone 8 mg
-
Anesthetic: 5 ml
- Lidocaine 1% OR
- Bupivacaine 0.25% or 0.5%
V. Technique: Landmark
- Patient in lateral recumbent position
- Hip flexed to 30 to 50 degrees
- Knee flexed to 60 to 90 degrees
- Palpate greater trochanter area for maximal tenderness
- Mark areas of maximal tenderness
- Inject under sterile conditions
- Insert needle perpendicular to skin at marked area
- Insert to bone, withdraw 3 mm and inject 1 ml
- Withdraw needle and insert at next Tender Point
- Inject 1 ml at each point of tenderness
VI. Technique: Ultrasound Guided
- Curvilinear transducer 5 MHz
- Position transducer horizontally, transverse to femur
- Identify the greater trochanter lateral facet
- Injection site is at bursa, between the gluteus medius tendon and the overlying IT Band
VII. References
- Greene (2001) Musculoskeletal Care, AAOS, p. 335-6
- Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]
- Webb (2024) Am Fam Physician 109(1): 61-70 [PubMed]