Clinical Trials Logo

Clinical Trial Summary

We hypothesize that local ultrasound guided injection with corticosteroid and local anaesthetic are effective on the symptoms of GTPS.


Clinical Trial Description

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. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT01807962
Study type Interventional
Source University Hospital, Geneva
Contact
Status Terminated
Phase Phase 3
Start date November 2011
Completion date December 2015

See also
  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