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Effectiveness of Ultrasound-Guided Corticosteroid Injection for the Treatment of Gluteus Medius Tendinopathy

¹ Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Pavillon Saint-Luc, 1058 rue Saint-Denis, Montréal, QC, Canada H2X 3J4.
² Physical Medicine & Rehabilitation Division, CHUM, Montréal, QC, Canada.
³ Service de Santé, Université de Montréal, Montréal, QC, Canada.
⁴ Centre de Physiatrie Dorchester, Montréal, QC, Canada.
⁵ Division of Clinical Epidemiology, McGill University Health Center, Montréal, QC, Canada.

OBJECTIVE. The objective of our study was to evaluate the effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy.

SUBJECTS AND METHODS. We prospectively evaluated 54 consecutive patients (48 women, six men; mean age, 54.7 years; mean body mass index, 26 kg/m²) with a clinical diagnosis of gluteus medius tendinopathy. Pain assessment using a 10-cm visual analog scale (VAS) was obtained as part of the initial clinical evaluation of all patients. A hip ultrasound study was performed followed by a gluteus medius peritendinous ultrasound-guided injection of 30 mg of triamcinolone combined with 3 mL of bupivacaine 0.5% using an anterior oblique coronal plane. One month after treatment, participants were reassessed clinically, and they were asked to quantify their pain using the VAS pain score and their satisfaction with the outcome of the injection using a 4-point rating scale (very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied). Statistical analysis included a paired Student's t test (comparison of pain levels before and after treatment, p = 0.05) and a multivariate analysis of covariance.

RESULTS. There was a 55% average reduction of pain level before versus after treatment (mean VAS pain score, 6.4 vs 2.9 cm, respectively; p < 0.001). One month after treatment, 72% of the patients showed a clinically significant improvement in pain level, which was defined as a reduction in the VAS pain score of 30%. Seventy percent of patients were satisfied with the results of the intervention. No correlation was shown between treatment outcome and any of the clinical variables or ultrasound findings.

CONCLUSION. Our study shows that a peritendinous ultrasound-guided corticosteroid injection may be an effective treatment of gluteus medius tendinopathy.

Keywords: gluteus medius tendinopathy • greater trochanteric pain syndrome • hip joint • ultrasound guidance • ultrasound-guided corticosteroid injection

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