Comparison of the effects of ultrasound-guided steroid injection and anatomic landmark-guided injection on pain and disability in greater trochanteric pain syndrome

Abstract

Objective: Greater trochanteric pain syndrome (GTPS) is a prevalent condition that can significantly affect patient comfort and function. This study aims to compare the effectiveness of ultrasound (USG)-guided and anatomic landmark-guided corticosteroid injections in managing GTPS. Methods: Patients diagnosed with GTPS received either USG or anatomic landmark-guided corticosteroid injections. Pain scores (Visual Analog Scale, VAS) and functional outcomes (modified Harris Hip Score, HHS) were assessed at baseline, 1 month, and 1 year post-injection. Cost-effectiveness was calculated using public and private payor pricing from June 2024. Results: Both treatment groups exhibited significant improvements in pain and function. The USG group demonstrated greater initial improvements at the 1-month mark, particularly in VAS activity and HHS. However, these differences between the groups converged over time, with similar long-term outcomes observed in these parameters. The USG-guided injections showed more pronounced initial benefits, especially for patients with higher initial pain levels and lower functional scores. USG was found to be more cost-effective in terms of HHS, but not VAS measures. Conclusion: While both USG and anatomic landmark-guided injections are effective for managing GTPS, USG-guided injections may provide greater initial relief in pain and function, particularly for patients with higher initial pain levels. USG does not demonstrate long-term superiority over anatomic injections. The study underscores the importance of evaluating long-term outcomes to comprehensively assess the sustained effectiveness of different treatment strategies for GTPS. Level of Evidence: Level III, Therapeutic study.