Greater trochanteric pain syndrome: Does imaging‐identified pathology influence the outcome of interventions?. (6th December 2013)

• Record Type: Journal Article
• Authors: Wilson, Shayne A.; Shanahan, Ernst M.; Smith, Malcolm D.
• Is Part Of: International journal of rheumatic diseases. Volume 17:Number 6(2014)
• Page Start: 621
• Page End: 627
• Publication Date: 2013-12-06
• Subjects: lateral hip pain -- radiological investigations -- steroid injections; Rheumatology -- Periodicals; Rheumatology -- Asia -- Periodicals; Rheumatology -- Pacific Area -- Periodicals; Rheumatic Diseases -- Periodicals; Connective Tissue Diseases -- Periodicals; Immune System Diseases -- Periodicals; 616.723
• DOI: 10.1111/1756-185X.12250
• Languages: English
• ISSNs: 1756-1841

Abstract

Abstract: Aim: To assess the outcomes for patients seen in a rheumatology service presenting with features of the greater trochanteric pain syndrome (GTPS) and the impact of imaging results on the outcomes of treatment. Methods: Retrospective audit, using a phone interview was performed to establish links between results of imaging undertaken in the diagnostic work‐up of patients with lateral hip pain and clinical outcomes for these patients. Patient perceptions of the effectiveness of interventions were also assessed. Results: Forty‐five patients were included (82% female, mean age 69.6 years). Sixty‐nine percent underwent radiological work‐up, including plain X‐rays (55%), computed tomography scans (64%), magnetic resonance imaging (48%) and ultrasound (90%). Coexistent trochanteric bursitis (TB) and gluteal tendinopathy were the most commonly elucidated pathologies accounting for the symptomatic presentation of 40% of patients. Forty‐one patients underwent some form of intervention, most commonly injection of local anesthetic and corticosteroid (LACS) into the region of the TB (87%), two‐thirds of which were undertaken under radiological guidance. Pain reduction was maximal following the third injection, with a significantly better response to unguided interventions and levels of symptomatic relief following the first injection being a good indicator of the probability of complete remission. Radiological demonstration of isolated TB correlated with a greater reduction in lateral hip symptoms following LACS TB injections both in the immediate post‐injection phase and in the long‐term. Conclusion: The results of this audit suggest that the management of GTPS has reasonable patient outcomes; however, a prospective study with greater patient numbers is needed to confirm these results.