USE OF ULTRASOUND IN ‘TROCHANTERIC BURSITIS’.

2006 
31 patients, between the ages of 59 and 74 years, were referred to one onrthopaedic consultant as trochanteric bursitis. All were females. Of these 7 patients were diagnosed as osteoarthritis of the hip or underwent further investigations for spinal conditions. 24 patients were clinically diagnosed as trochanteric bursitis. All these patients had ultrasound examination of the hips by a radiologist with a special interest in musculoskeletal diseases. Except for one patient the rest had either gluteus medius inflammation or tears with or without involvement of gluteus minimus. All these patients with positive findings had 80mg of depomedrone injection under USG guidance. At 6 weeks follow up 21 had complete relief of symptoms. 4 had recurrence of symptoms at 3 months when they had another dose of depomedrone und USG guidance. At one year 18 were free of symptoms and the 3 with some recurrence of symptoms did not want any intervention. Discussion: Etiology of greater trochanteric pain syndrome has been a source of considerable debate. Empirical treatment with ‘blind’ steroid injection is the usual course of action. In unresolving trochanteric bursitis excision of trochanteric bursa has been advocated. Gluteus medius and minimus tears have been referred to as rotator cuff tears of the hip (1). Our study shows an association between trochanteric bursitis and ‘rotator cuff tears of hip’. Ultrasound guided steroid injection can give a better success rate of ‘hitting the right spot’. Further investigations are required to identify whether this association could be a cause and effect relationship.
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