Procedure

Trochanteric Bursa Injection

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Trochanteric Bursa Injection

  • Efficacy
  1. Single injection associated with 2.7 fold increase in those pain-free at 5 years
    1. Lievense (2005) Br J Gen Pract 55(512): 199-204 [PubMed]
  • Preparation
  1. Needle
    1. Gauge: 22-25
    2. Length: 1.5 inch (3.0 inch spinal needle if obese)
  2. Intraarticular Corticosteroid
    1. Methylprednisolone: 1 ml of 40 mg/ml or
    2. Betamethasone (Celestone Soluspan): 1 ml
  3. Lidocaine 1%: 5 ml
  • Technique
  1. Patient in lateral recumbent position
    1. Hip flexed to 30-50 degrees
    2. Knee flexed to 60-90 degrees
  2. Palpate greater trochanter area for maximal tenderness
    1. Mark areas of maximal tenderness
  3. Inject under sterile conditions
    1. Insert needle perpendicular to skin at marked area
    2. Insert to bone, withdraw 3 mm and inject 1 ml
    3. Withdraw needle and insert at next Tender Point
    4. Inject 1 ml at each point of tenderness
  • References
  1. Greene (2001) Musculoskeletal Care, AAOS, p. 335-6
  2. Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]