A Target Crosshair Method for Fluoroscopic-Guided Greater Trochanteric Bursa Injections.

Abstract

Background: Trochanteric bursitis is one of the most common causes of lateral hip pain. Although fluoroscopic-guided greater trochanteric bursa injections (FGTBIs) are commonly performed, literature describing techniques and methods focused on accuracy and precision is scarce.

Objectives: In this case report, we describe an innovative target crosshair method (TCM) to help improve FGTBI procedural accuracy and precision under fluoroscopic guidance.

Study design: The design of this study is a retrospective chart review in the form of a technical methodology report.

Setting: This study was completed at a large tertiary academic medical center.

Methods: The TCM utilizes anteroposterior (AP) and lateral fluoroscopic views of the proximal femur in order to draw a vertical line (AP) at the level of the junction of the femoral neck, trochanteric fossa, and greater trochanter (GT), and a horizontal line (craniocaudal) along the lateral hip designating the posterior half of the GT.

Results: Three patients with body mass indexes ranging from 35-40 successfully underwent FGTBI using the TCM for greater trochanteric syndrome causing lateral hip pain. All patients experienced > 70% analgesic relief for 4 to 6 months. There were no adverse events reported by any of the patients.

Limitations: The limitations of this study include the inability to generalize results due to a small sample size and the inherent nature of the study design as a retrospective chart review. The primary intention of this study is to describe a novel technical method.

Conclusions: The TCM results in an accurate path for skin and subcutaneous tissue local anesthetic injection and a final needle tip landing site for corticosteroid injection regardless of patient body habitus.