Procedure

Trochanteric Bursa Injection

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Trochanteric Bursa Injection

  • See also
  1. Trochanteric Bursitis
  2. Hip Injection
  3. Joint Injection
  4. Injectable Corticosteroid
  5. Tendon Sheath Injection
  • Indication
  1. Trochanteric Bursitis
  • 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 to 25
    2. Length: 1.5 inch (3.0 or 3.5 inch spinal needle in larger adults)
  2. Intraarticular Corticosteroids (choose one)
    1. Methylprednisolone: 1 ml of 40 mg/ml OR
    2. Betamethasone (Celestone Soluspan): 1 ml of 6 mg/ml
    3. Triamcinolone 40 mg
    4. Dexamethasone 8 mg
  3. Anesthetic: 5 ml
    1. Lidocaine 1% OR
    2. Bupivacaine 0.25% or 0.5%
  • Technique
  • Landmark
  1. Patient in lateral recumbent position
    1. Hip flexed to 30 to 50 degrees
    2. Knee flexed to 60 to 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
  1. Curvilinear transducer 5 MHz
  2. Position transducer horizontally, transverse to femur
  3. Identify the greater trochanter lateral facet
    1. Injection site is at bursa, between the gluteus medius tendon and the overlying IT Band
  • References
  1. Greene (2001) Musculoskeletal Care, AAOS, p. 335-6
  2. Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]
  3. Webb (2024) Am Fam Physician 109(1): 61-70 [PubMed]