Greater Trochanteric Bursa Injection
Evidence Grade C: For safe, curative treatment of painful symptoms.
Obtain informed consent from the patient.
Gather appropriate materials needed for the procedure.
Pay attention to the patient's body habitus when choosing a needle length. Usually a 1.5-inch needle will suffice for thinner people, but you may need up to a four-inch needle for more obese patients.
First, draw up 4cc of 1-2% lidocaine into a 5-10cc syringe.
Then draw up the steroid into the same syringe in order to intermix the two together. You may use this list of four commonly used steroids as a reference.
Position the patient in the lateral decubitus position so that they are lying on the unaffected side.
Next, palpate the greater trochanter and identify the point of maximal tenderness.
In this image: The patient lies on the unaffected side in preparation for the injection.
Cleanse the skin with povidone-iodine solution or an alcohol swab.
Using a 22- to 25-gauge needle, insert the needle perpendicular to the skin overlying the point of maximal tenderness.
Advance the needle until you reach the bony prominence of the greater trochanter. Then, withdraw the needle slightly and begin to infiltrate the area.
Redirect the needle to several places within the same coronal plane and inject the medication to each site.
