AJR: Ultrasound-guided cortisone injections improve hip pain for most patients

Peritendinous ultrasound-guided corticosteroid injections may be an effective treatment method of gluteus medius tendinopathy, said a study published in this month's issue of the American Journal of Roentgenology.

Julie Labrosse, MD, and Étienne Cardinal MD, of the department of radiology at University of Montreal’s Hospital Center in Montreal, and colleagues sought to determine whether ultrasound-guided treatments could be deemed effective in the treatment of gluteus medius tendinopathy, a condition typically presented in active, young individuals and middle-aged to elderly women that is triggered by injury to tendons in the buttocks.

The authors concluded that 72 percent of patients noted a clinically significant improvement in their pain level after follow up.

The study prospectively evaluated 48 women and six men, with a mean age of 54.7 years. who had been diagnosed with gluteus medius tendinopathy.  A hip ultrasound was first performed, followed by a gluteus medius peritendinous ultrasound-guided injection of 30 mg of triamcinolone combined with 3 mL of bupivacaine to all of the 54 patients involved in the study.

The condition--which can cause severe hip pain--is typically treated with physiotherapy, nonsteroidal anti-inflammatory medication and local injections of corticosteroids.

The participants were asked to evaluate their pain initially utilizing a 10-cm visual analog scale (VAS). After a one-month follow up period, the participants were asked to reevaluate their pain using the VAS scale, as well as their satisfaction with the outcomes of the injection using a four-point rating scale (very satisfied, somewhat satisfied, somewhat dissatisfied or very dissatisfied).

After one month, the study determined that 72 percent of patients noted improvement in pain levels and 70 percent of the participants were satisfied with the treatment.

“This noninvasive, nonionizing imaging technique allows continuous monitoring of the needle position, which facilitates the performance of safe and precise cortisone injections,“ concluded Cardinal.

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