Ultrasound-Guided Cortisone Injection for Greater Trochanteric Pain Syndrome

 Greater Trochanteric Pain Syndrome (GTPS) is a condition that causes pain on the outer side of the hip. It is commonly linked to irritation or inflammation around the bony prominence known as the greater trochanter. This area is where several tendons attach, and it is also where a fluid-filled sac called the bursa is located.

People with GTPS often experience pain when lying on the affected side, climbing stairs, or standing after sitting for long periods. The condition can affect daily movement and activities, making management important.

At Joint Injections, clinicians provide detailed assessment and use ultrasound-guided cortisone injections as one option to help manage this type of hip pain.

Anatomy of the Hip and Greater Trochanter

The hip joint is a ball-and-socket joint made up of the femur (thigh bone) and pelvis. On the outer side of the upper femur is the greater trochanter. This bony prominence serves as an anchor point for muscles and tendons that control hip movement, including the gluteus medius and gluteus minimus.

Next to the tendons lies a bursa, which is a small sac filled with fluid. The bursa helps reduce friction between tissues during movement. In GTPS, the tendons or the bursa can become irritated, causing pain on the outside of the hip.

Pathology of GTPS

GTPS is not caused by one single problem. It often results from a combination of factors, such as:

  • Irritation or degeneration of the gluteal tendons near the greater trochanter.
  • Inflammation or swelling of the trochanteric bursa.
  • Repetitive strain from activities like running, climbing, or prolonged standing.
  • Muscle weakness or imbalance around the hip.

Over time, these issues may lead to pain, stiffness, and discomfort, especially during movement or pressure on the hip.

Symptoms

Common symptoms of GTPS include:

  • Pain over the outer hip, sometimes spreading down the thigh.
  • Pain when lying on the affected side.
  • Tenderness when pressing the side of the hip.
  • Discomfort with walking, climbing stairs, or standing from sitting.
  • Stiffness in the hip region.

Risk Factors

Certain factors can increase the risk of developing GTPS:

  • Repetitive activities involving the hip.
  • Weakness of hip stabilising muscles.
  • Changes in walking pattern or posture.
  • Previous hip, knee, or back problems.
  • Middle age and female gender, although it can affect anyone.

Diagnosis

Diagnosis usually begins with a clinical assessment by a clinician. This involves:

  • A detailed history of symptoms.
  • Physical examination, including palpation of the greater trochanter.
  • Tests for hip movement and muscle strength.
  • Ultrasound may be used to look at the tendons and bursa in more detail.

Management of GTPS

Management can involve several approaches. These may include:

  • Rest and activity modification.
  • Pain management strategies.
  • Cortisone injections for inflammation around tendons or the bursa.
  • Surgery in rare or persistent cases.

Role of Ultrasound-Guided Cortisone Injections

At Joint Injections, clinicians use ultrasound-guidance to carry out cortisone injections. Ultrasound provides a real-time image of the hip structures, allowing precise delivery of cortisone to the target area.

This approach can help ensure accuracy, particularly when injecting near tendons or into the bursa around the greater trochanter.

Mechanism of Action of Cortisone

Cortisone is a type of corticosteroid. It works by:

  • Reducing local inflammation in the tendon or bursa.
  • Decreasing sensitivity of irritated tissues.
  • Helping reduce swelling in the affected area.

When delivered with ultrasound guidance, cortisone is placed exactly where it is needed, improving precision.

Benefits of Ultrasound Guidance

The use of ultrasound during cortisone injections provides several benefits:

  • Real-time visualisation of the hip structures.
  • Increased precision in targeting the affected tissue.
  • Avoiding surrounding structures such as blood vessels or nerves.
  • Supporting safe and accurate placement of the injection.

Why Choose Joint Injections for GTPS

At Joint Injections, clinicians focus on accurate diagnosis and precise treatment. With expertise in ultrasound-guided injections, the clinic provides careful and targeted management options for conditions such as Greater Trochanteric Pain Syndrome.

The use of ultrasound ensures injections are delivered with accuracy, tailored to the individual’s presentation.

Conclusion

Greater Trochanteric Pain Syndrome is a common condition that causes pain around the outer hip. It can be linked to tendon irritation or bursitis and may interfere with daily activities.

At Joint Injections, ultrasound-guided cortisone injections are one of the options used to manage this condition. By combining accurate diagnosis with targeted treatment, clinicians are able to provide an approach that focuses on precision and patient-centred care.


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