Bursitis Clinical Trial
Official title:
A Randomised Double Blind Controlled Trial of Injection of Local Anaesthetic and Corticosteroid Under Ultrasound Control in the Greater Trochanteric Pain Syndrome.
We hypothesize that local ultrasound guided injection with corticosteroid and local anaesthetic are effective on the symptoms of GTPS.
The greater trochanteric pain syndrome (GTPS) is a frequent soft tissue syndrome which is
often not recognised by medical practitioners. Currently, there is no validated definition
of this syndrome and it is classically defined as pain and tenderness in the region of the
greater trochanter that may radiate down to the postero-lateral aspect of the thigh and may
mimic nerve root compression.
The prevalence of GTPS amongst adult patients referred to a spine clinic for chronic low
back pain (LBP) has been reported to be 20-35%. In addition to pain, GTPS induces functional
disability which at times may profoundly interfere with patients' daily activities. The
diagnosis of GTPS is suspected in a patient complaining of lateral hip pain. The
reproduction of typical pain on palpation of the posterior part of the greater trochanter is
the only well recognised clinical sign, although other clinical signs have been described.
As is frequently the case with these type of syndromes, the physiopathology of GTPS is
probably a mixture of several musculoskeletal problems, among which trochanteric bursitis
and gluteus medius (GMe) tendinosis are the most frequently cited.
MRI studies have demonstrated GMe tendinosis or tears in patients with GTPS and MRI is used
as the gold standard for the diagnosis of GTPS in many studies. Musculoskeletal ultrasound
(US) is of increasing interest among rheumatologists. It readily demonstrates soft tissue
lesions, fluid collections, allows dynamic examination and the undertaking of ultrasound
guided procedures. GMe and gluteus minus (GMi) tendinopathy or tears as well as bursitis can
be clearly demonstrated by ultrasound and US may guide steroid injection for the treatment
of GMe tendinopathy. However, to date no study has compared the utility of MRI compared to
US.
There are very few well-performed studies regarding the treatment of GTPS. Although poorly
studied, analgesics and non steroidal anti-inflammatory drugs (NSAIDs) are often used as
first line therapy. The duration of therapy required with these oral agents is unknown and
there are significant potential side-effects from these treatments. The vast majority of
patients referred to secondary or tertiary centres have failed these oral therapies. Some
authors advocate physiotherapy (massage or stretching) but once again, there is no strong
evidence to support this approach. Thus, most patients are treated with an injection of a
combination of steroids and local anaesthetic. However, there is no convincing evidence in
the literature that this practice is effective.
The use of musculoskeletal ultrasound (US) has been shown to improve the accuracy of
corticosteroid injections for many joints and extra-articular structures such as bursa and
tendon sheaths. Although small observational studies have suggested that local
corticosteroid injection may be effective in the short term, no prospective controlled study
has been carried out to establish the efficacy of this common intervention.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT01205477 -
Safety and Efficacy of Methylprednisolone Infiltration in Anserine Bursitis Treatment
|
Phase 2 | |
Completed |
NCT01050465 -
MedlinePlus Health Prescriptions: Developing a Pragmatic Approach for Clinic Use
|
N/A | |
Completed |
NCT02841462 -
Hydrothermal Ablation in Recurrent and Chronic Symptomatic Bursitis
|
N/A | |
Withdrawn |
NCT00863889 -
Steroid Injection for the Treatment of Greater Trochanteric Pain Syndrome
|
Phase 4 | |
Completed |
NCT00480675 -
Randomized Study Comparing Fluoroscopically-Guided Versus Blinded Trochanteric Bursa Injections
|
N/A | |
Withdrawn |
NCT00914836 -
Comparison of 2 Doses of Corticosteroid Subacromial Injections for the Treatment of Painful Shoulder
|
N/A | |
Completed |
NCT00352625 -
Ketoprofen Topical Patch 20% in the Treatment of Pain Associated With Shoulder, Elbow or Knee Tendonitis or Bursitis
|
Phase 3 | |
Terminated |
NCT04931511 -
Comparison Between Subacromial Ultrasound Guided and Systemic Steroid Injection for Frozen Shoulder
|
Phase 4 | |
Completed |
NCT01161615 -
MRX-7EAT Etodolac-Lidocaine Topical Patch in the Treatment of Tendonitis and Bursitis of the Shoulder
|
Phase 3 | |
Terminated |
NCT00426985 -
Efficacy and Safety of Ketoprofen Topical Patch 20% in the Treatment of Pain Associated With Shoulder, Elbow or Knee Tendonitis or Bursitis
|
Phase 3 | |
Completed |
NCT00634608 -
Integrating Targeted MedlinePlus Health Prescriptions Into Clinic Practice Workflow
|
N/A | |
Completed |
NCT01506154 -
Safety & Efficacy Study of MRX-7EAT Patch in the Treatment of Pain of the Shoulder
|
Phase 3 | |
Completed |
NCT02221817 -
Comparison of Ultrasound Guided Versus Blind Corticosteroid Injection for Trochanteric Bursitis
|
N/A | |
Completed |
NCT02126878 -
Comparison of Steroid Dosages on the Efficacy of Trochanteric Bursa Injection
|
N/A |