1.  With the patient lying on the examination table in the lateral decubitus position on the unaffected hip, the clinician stands behind the patient.

2.  Identify and mark the area(s) of maximal tenderness over the greater trochanter.

3.  At that area, press firmly on the skin with the retracted tip of a ballpoint pen. This indention represents the entry point(s) for the needle.

4.  After the landmarks are identified, the patient should not move the hip.

1.  Prep the insertion site(s) with alcohol followed by the povidone–iodine pads.

2.  Achieve good local anesthesia by using topical vapocoolant spray.

3.  Position the needle and syringe perpendicular to the skin with the tip of the needle directed medially.

4.  Using the no-touch technique, introduce the needle at the insertion site(s).

5.  Advance the needle toward the femoral trochanter until the needle tip touches the bone. Back up the needle 1 to 2 mm.

6.  Inject the steroid solution as a bolus steadily in the area of the trochanteric bursa. The injected solution should flow smoothly into the space. If increased resistance is encountered, advance or withdraw the needle slightly before attempting further injection.

7.  Repeat the injection at other adjacent painful areas if needed.

8.  Following injection(s) of the corticosteroid solution, withdraw the needle.

9.  Apply a sterile adhesive bandage(s).

10.  Instruct the patient to massage the area and move his or her hip through its full range of motion. This movement distributes the steroid solution throughout the trochanteric bursa.

11.  Reexamine the area of the trochanteric bursa in 5 min to confirm pain relief (Fig. 8.11).