Greater Trochanteric Bursa/Gluteus Medius Injection: Ultrasound Guidance




Abstract


Greater trochanteric pain syndrome (GTPS), known as the Great Masquerader, can often be mistaken for other hip or lumbar pathologies. GTPS presents with pain over the lateral hip, with possible radiation into the lateral thigh. Several muscles insert at or near the greater trochanter of the femur, which is composed of tendon attachment points including the superoposterior, lateral, and anterior facets. There are three main bursae that can be a source of pain: the subgluteus maximus (trochanteric bursa) located between the gluteus maximus and gluteus medius tendons, the subgluteus medius located deep to the insertion of the gluteus medius on the lateral facet, and the subgluteus minimus bursa deep to the insertion of the gluteus minimus on the anterior facet.




Keywords

bursitis, Gluteus Medius, Greater trochanteric bursa, Iliotibial band, ultrasound

 



Note: Please see pages ii , iii for a list of anatomic terms/abbreviations used throughout this book.


Greater trochanteric pain syndrome (GTPS), known as the Masquerader, can often be mistaken for other hip or lumbar pathologies. GTPS presents with pain over the lateral hip, with possible radiation into the lateral thigh. Several muscles insert at or near the greater trochanter of the femur, which is composed of tendon attachment points including the superoposterior, lateral, and anterior facets. There are three main bursae that can be a source of pain: the subgluteus maximus (trochanteric bursa) located between the gluteus maximus and gluteus medius tendons, the subgluteus medius located deep to the insertion of the gluteus medius on the lateral facet, and the subgluteus minimus bursa deep to the insertion of the gluteus minimus on the anterior facet.


Ultrasound guidance ensures accurate needle placement into the intended bursae. In this chapter, we will present an in-plane technique, short axis to the gluteus medius tendon, which may be used to inject both the subgluteus medius and greater trochanteric bursae. We will also demonstrate out-of-plane confirmation. Safety considerations include avoiding an intratendinous injection.


Jan 27, 2019 | Posted by in RHEUMATOLOGY | Comments Off on Greater Trochanteric Bursa/Gluteus Medius Injection: Ultrasound Guidance
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