超声引导下皮质类固醇注射治疗大转子疼痛综合征：大转子滑囊与臀中肌下滑囊。
Ultrasound-guided corticosteroid injections for treatment of greater trochanteric pain syndrome: greater trochanter bursa versus subgluteus medius bursa.
机构信息
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
出版信息
AJR Am J Roentgenol. 2013 Aug;201(2):W313-7. doi: 10.2214/AJR.12.9443.
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of corticosteroid injections into the greater trochanteric bursa as opposed to the subgluteus medius bursa in patients with greater trochanteric pain syndrome.
MATERIALS AND METHODS
We retrospectively reviewed 183 injections (149 performed in women, 34 performed in men; age range 23-90 years; median, 53 years) performed for treatment of greater trochanteric pain syndrome. A 10-cm visual analog scale survey was used to assess pain level before the procedure and 14 days after the procedure. A 3-mL corticosteroid solution was injected into either the greater trochanteric bursa or the subgluteus medius bursa under direct ultrasound guidance. Procedure images were retrospectively reviewed to determine the site of injection. Diagnostic images obtained at the time of the procedure were also reviewed for findings of tendinopathy, bursitis, and enthesopathy. Statistical analysis of differences in pain reduction was performed, as was analysis for association between pain relief and demographic variables of age, sex, previous injections, and ultrasound findings.
RESULTS
Sixty-five injections met the inclusion criteria; 56 performed in women and nine performed in men (age range, 30-82 years; median, 53 years). Forty-one injections were into the greater trochanteric bursa and 24 into the subgluteus medius bursa. There was a statistically significant difference in pain reduction between greater trochanteric bursa and subgluteus medius bursa injections with a median pain reduction of 3 as opposed to 0 (p < 0.01). There was no statistically significant association between pain relief and demographic variables or ultrasound findings.
CONCLUSION
Corticosteroid injections into the greater trochanteric bursa may be more effective than injections into the subgluteus medius bursa for treatment of greater trochanteric pain syndrome.
目的
本研究旨在评估在治疗大转子疼痛综合征时，将皮质类固醇注射到大转子滑囊与臀中肌下滑囊的疗效。
材料和方法
我们回顾性分析了 183 例（女性 149 例，男性 34 例；年龄 23-90 岁；中位数 53 岁）接受大转子疼痛综合征治疗的注射。采用 10cm 视觉模拟评分量表在治疗前和治疗后 14 天评估疼痛程度。在超声引导下，将 3ml 皮质类固醇溶液直接注射到大转子滑囊或臀中肌下滑囊中。回顾性分析图像以确定注射部位。还回顾了在操作过程中获得的诊断图像，以评估腱病、滑囊炎和附着病的发现。对疼痛减轻的差异进行了统计学分析，并对疼痛缓解与年龄、性别、既往注射和超声结果等人口统计学变量之间的相关性进行了分析。
结果
符合纳入标准的 65 例注射；56 例女性和 9 例男性（年龄 30-82 岁；中位数 53 岁）。41 例注射到大转子滑囊，24 例注射到臀中肌下滑囊。大转子滑囊和臀中肌下滑囊注射的疼痛减轻程度存在统计学显著差异，中位数疼痛减轻 3 分，而不是 0 分（p <0.01）。疼痛缓解与人口统计学变量或超声结果之间无统计学显著关联。
结论
在治疗大转子疼痛综合征时，将皮质类固醇注射到大转子滑囊可能比注射到臀中肌下滑囊更有效。
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