Point-of-Care Ultrasound in Greater Trochanteric Pain Syndrome

Point-of-Care Ultrasound in Greater Trochanteric Pain Syndrome (GTPS)

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.

Study Overview

• Status: Completed
• Conditions: Greater Trochanteric Pain Syndrome

Detailed Description

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 (Actual): 100

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02114
      • Massachusetts General Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Outpatient rheumatology clinic

Description

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

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain with rest measured by a numeric rating scale		Baseline and 2 weeks
Pain with activity as measured by a numeric rating scale		Baseline and 2 weeks
Demographics- composite	age, gender, race/ethnicity, education, occupation, comorbidities, overall health status.	Baseline
Pressure point threshold as measured by an algometer		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	Baseline

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital
• Investigators: Principal Investigator: Minna J. Kohler, M.D., Massachusetts General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2012
• Primary Completion (Actual): August 1, 2015
• Study Completion (Actual): August 1, 2015

Study Registration Dates

• First Submitted: July 11, 2012
• First Submitted That Met QC Criteria: July 13, 2012
• First Posted (Estimate): July 17, 2012

Study Record Updates

• Last Update Posted (Actual): August 29, 2022
• Last Update Submitted That Met QC Criteria: August 24, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: trochanteric bursitis; greater trochanteric pain syndrome; lateral hip pain
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease; Joint Diseases; Musculoskeletal Diseases; Syndrome; Somatoform Disorders; Bursitis
• Other Study ID Numbers: 2012p001126

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No