Point-of-Care Ultrasound in Greater Trochanteric Pain Syndrome

N/ACompletedNCT01642043

Massachusetts General Hospital100 enrolled

Overview

Greater trochanteric pain syndrome (GTPS) is a common cause of musculoskeletal pain. The primary aim of this study is to describe the soft tissue and bony structural ultrasound (US) findings identified in the lateral hip and iliotibial band (ITB) in patients presenting with greater trochanteric pain syndrome (GTPS) in an outpatient rheumatology clinic.

GTPS, widely known as trochanteric bursitis, encompasses a spectrum of disorders (gluteal tendinopathy, tears, bursitis, and ITB syndrome) that are difficult to distinguish by clinical exam alone. Better understanding of US imaging characteristics in relation to clinical symptoms may be helpful in identifying those patients who would most benefit from corticosteroid injections and other non-operative treatment options. Point-of-care musculoskeletal US use has been shown to reduce repeated hospital appointments, improve accuracy of diagnosis, and provide expedited treatment, thus improving quality of care in an outpatient musculoskeletal clinic. US assessment is not routinely included in the management of GTPS patients and ideal imaging modalities are not established.

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

Greater Trochanteric Pain Syndrome

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Lateral hip pain thought to be due to GTPS as evidenced by tenderness to palpation of the lateral hip over the greater trochanter * Have a pain score of at least 2 out of 10 on an 11-point numeric rating scale * Lateral hip pain for at least 1 week * For participants with bilateral GTPS, the most symptomatic hip will be considered the study hip * Have a telephone Exclusion Criteria: * Inability to give informed consent * BMI \> 40 * Evidence of severe OA of the study hip by X-ray * Avascular necrosis of the study hip * Groin pain at rest or with log-rolling * Hip internal rotation range of motion \< 15 degrees * Prior fracture involving the study hip or femur * Prior hip surgery or prosthesis in the painful hip * Paralysis or paresis of the lower extremity * Wheelchair bound * Open wound or skin lesions in the lateral hip

Locations (1)

Massachusetts General Hospital

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Descriptive diagnostic ultrasound findings of the bony and soft tissue structures of the lateral hip and iliotibial band

Presence of tendinopathy, tendon tears, bursitis, enthesophytes, calcifications

Time frame: Baseline

Secondary Outcomes

Pain with rest measured by a numeric rating scale

Time frame: Baseline and 2 weeks

Pain with activity as measured by a numeric rating scale

Time frame: Baseline and 2 weeks

Demographics- composite

age, gender, race/ethnicity, education, occupation, comorbidities, overall health status.

Time frame: Baseline

Pressure point threshold as measured by an algometer

Time frame: Baseline

Clinical data: Predictors of treatment response- composite

* Duration of pain * Body Mass Index * Physical exam findings * Treatments tried in the past * Presence of back pain

Time frame: Baseline

Data from ClinicalTrials.gov

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