Trochanteric Bursa Injection

Chapter 48 Trochanteric Bursa Injection



Common indications


Inflammation of the trochanteric bursa leads to chronic, intermittent pain along the lateral hip and tenderness directly over the trochanteric bursa. Corticosteroid injection into the inflamed bursa can effectively improve pain without the systemic side effects of oral antiinflammatory medications. Trochanteric bursitis can mimic other conditions, including disk disease and hip-joint disease, so it is important to consider other diagnoses before proceeding to treatment (Figure 48-1).


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FIGURE 48-1 Trochanteric bursitis.



Equipment


The equipment includes sterile gloves, povidone-iodine wipes or alcohol wipes, a 22-gauge, 1½- to 2-in. needle and a 5-cc syringe, 1% lidocaine without epinephrine, 20 to 40 mg of methylprednisolone acetate or the equivalent, and an adhesive bandage dressing (Figure 48-2).


image

FIGURE 48-2 Equipment.



Key steps



1. Prepare the patient: Inform the patient of the risks, benefits, and possible complications of injection therapy. Place the patient in a comfortable position on the examining table, and drape the area, leaving the lateral hip exposed. Carefully palpate the lateral thigh. Find the point of maximal tenderness over the prominence of the greater trochanter. Identify the site of entry, and mark it with a thumbnail, ballpoint pen, or indelible marker (Figure 48-3). Prep the area with alcohol or povidone-iodine (Figure 48-4).

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Dec 12, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Trochanteric Bursa Injection

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