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 longterm 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.