Ultrasound-guided injections for the retrotrochanteric region: A cadaveric investigation.

IF 2.2 4区医学 Q1 REHABILITATION

PM&R Pub Date : 2025-05-12 DOI:10.1002/pmrj.13381

Kamal Mezian, Vincenzo Ricci, Ke-Vin Chang, Nimish Mittal, Jan Vacek, Ondřej Naňka, Levent Özçakar

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引用次数: 0

Abstract

Background: Injections for the piriformis and triceps coxae tendons/bursae have not been described and validated.

Objective: To investigate the deep retrotrochanteric anatomy and validate an ultrasound (US)-guided injection technique.

Methods: Fifteen sides of the pelvic half/lower limb of formalin-fixed cadaveric specimens were dissected to investigate the deep retrotrochanteric region. An US-guided superficial/peritendinous green latex dye injection was performed on both sides of a single full body cadaver. Next, seven sides of another four full body cadavers were injected using a deep/intrabursal technique. The cadavers were dissected to observe the dye's location.

Results: In the anatomical part of the study, we observed a consistent fusion of the piriformis tendon (PT) with the triceps coxae tendon (TCT) (15/15), and with the gluteus medius tendon in 93% (14/15). A bursa of piriformis was identified in 80% (12/15) of the cases, and a subtendinous bursa of obturator internus was found in 73% (11/15). A fat pad overlying the PT-TCT was present in 93% (14/15) of the cases. Regarding the US-guided injections, success rate for superficial/peritendinous injection was 0% (0/2), with the latex dye being identified in the fat pad covering the PT-TCT in both cases. For the deep/intrabursal injection, the success rate was 86% (6/7).

Conclusions: The results indicated a satisfactory success rate for the deep/intrabursal injection of PT-TCT in retrotrochanteric pain syndrome. This technique holds promise for the treatment of bursa and tendon pathologies in relevant patients.

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超声引导下转子后区注射：一项尸体调查。

背景：梨状肌和肱三头肌髋肌腱/滑囊的注射尚未被描述和证实。目的：探讨股骨粗隆后深部解剖及超声引导下注射技术的可行性。方法：解剖福尔马林固定尸体标本的骨盆半/下肢15侧，观察股骨粗隆后深区。在单个全身尸体的两侧进行了美国引导的浅表/包膜绿色乳胶染料注射。接下来，另外四具全身尸体的七个侧面使用深/肱内技术进行注射。尸体被解剖以观察染料的位置。结果：在本研究的解剖部分，我们观察到梨状肌腱（PT）与髋三头肌肌腱（TCT）（15/15）和臀中肌腱（14/15）的融合一致性为93%。80%（12/15）的病例发现梨状肌滑囊，73%（11/15）的病例发现闭孔内肌腱下滑囊。93%（14/15）的病例有脂肪垫覆盖PT-TCT。对于us引导注射，浅表/腱鞘注射的成功率为0%(0/2)，两种情况下，在覆盖PT-TCT的脂肪垫中都发现了乳胶染料。深/鞘内注射成功率为86%（6/7）。结论：PT-TCT在治疗转子后疼痛综合征中的应用具有良好的成功率。该技术有望治疗相关患者的滑囊和肌腱病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PM&R REHABILITATION-SPORT SCIENCES

CiteScore

4.30

自引率

4.80%

发文量

187

审稿时长

4-8 weeks

期刊介绍： Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.