Factors Associated with the Outcome of
Ultrasound-Guided Trochanteric Bursa Injection
in Greater Trochanteric Pain Syndrome: A
Retrospective Cohort Study
Authors: Park Yongbum 
Published: February 2021

Background: Trochanteric bursa injections of corticosteroids and local anesthetics have been shown
to provide pain relief for the treatment of greater trochanteric pain syndrome (GTPS). However,
symptom recurrence and incomplete symptom relief are common. The reason for the variation in
response is unclear but may be related to disease-, treatment-, or patient-related factors.
Objective: To determine whether there are factors related to patient, treatment, or disease that
can predict either the magnitude or duration of response to ultrasound-guided trochanteric bursa
injections for GTPS.
Study Design: Retrospective evaluation.
Setting: A university hospital outpatient center.
Methods: Potential study participants were patients who underwent ultrasound-guided
trochanteric bursa injection at an outpatient rehabilitation department. Follow-up interviews
were performed in a hospital visit at 1, 3, and 6 months after injection. The Harris Hip Score
and the Verbal Numeric Pain Scale were used to evaluate clinical effectiveness of pain reduction
and functional improvement at baseline, 1, 3, and 6 months after treatment. Clinical data and
ultrasound findings were obtained to assess the possible predictive factors for a good and durable
response to ultrasound-guided trochanteric bursa injection.
Results: Patients receiving ultrasound-guided trochanteric bursa injections had a statistically
significant improvement in pain and hip function at 1, 3, and 6 months after the last injections.
Of the 137 patients, 110 (80.3%), 95 (64.9%), and 77 (56.2%) patients achieved successful
outcomes according to their 1, 3, and 6-month follow-up evaluations, respectively. Univariate
analysis showed that patients with knee osteoarthritis and lumbar facet joint or sacroiliac joint pain
experienced less therapeutic effect than those without the conditions at 6 months post-injection.
Logistic regression analysis showed that the significant outcome predictors at the 6-month followup were facet joint or S-I joint pain (odds ratio = 0.304, P = .014) and knee osteoarthritis (odds
ratio = 0.329, P = .021). Age, gender, body mass index, and pain duration were not independent
predictors of a clinically successful outcome. There was no statistically significant association
between effective treatment and the ultrasound findings of tendinosis, bursitis, partial or fullthickness tear, and enthesopathic changes.
Limitations: Retrospective chart review without a control group.
Conclusions: This study suggests that knee osteoarthritis and lower back pain might be associated
with a poor outcome of ultrasound-guided trochanteric bursa injection for GTPS. Assessment of
these clinical factors should be incorporated into the evaluation and counseling of patients with
GTPS who are candidates for ultrasound-guided trochanteric bursa injection.
Key words: Bursa injection, corticosteroid, greater trochanteric pain syndrome, knee
osteoarthritis, lower back pain, lumbar facet joint, ultrasonography, S-I joint pain