Hannah Soliman, n/a
n/a
n/a
n/a, New York, United States
Madison Dwyer, BS
Medical Student
Albany Medical College
Albany, New York, United States
Zachary Nylund, BS
Medical Student
Albany Medical College
Albany, New York, United States
Michael Downing, DO
Resident Physician
Albany Medical Center
Albany, New York, United States
Joey Levy, DO
Fellow Physician
Albany Center for Pain Management
Saratoga Springs, New York, United States
Martin Ferrillo, DO
Attending Physician
Albany Center for Pain Management
Saratoga Springs, New York, United States
Bilateral Greater Trochanteric Pain Syndrome
Case Description: A 66-year-old male with history of bilateral L3-S1 facet arthropathy, myofascial pain syndrome, and greater trochanteric pain syndrome presented for recurrence of moderate-severe bilateral hip pain. He previously failed conservative treatment including physical therapy, oral medications, and had moderate improvement with lumbar RFA. Examination demonstrates reduced lumbar spine range of motion and significant tenderness over bilateral trochanteric bursa. At previous visits, he received bilateral greater trochanteric bursa injections with steroid-lidocaine combination resulting in 90% pain improvement for 8-weeks. Given the benefit from prior diagnostic bursa injections, targeted RFA of the right and left trochanteric hip bursa was performed resulting in 80% pain resolution and improved functional activity to date.
Discussions: Greater trochanteric pain syndrome (GTPS) encompasses a wide range of conditions that cause lateral hip pain, whether due to inflammation or mechanical dysfunction. Conventional treatments include nonsteroidal anti-inflammatories, physical therapy, activity modification, and corticosteroid injections. While injections into the greater trochanteric bursa may offer relief, symptoms frequently recur after weeks to months. Recent reports suggest that RFA may be an alternative treatment for GTPS. This strategy targets the sensory nerve of the greater trochanteric bursa. This branch of the femoral nerve can be targeted with ultrasound or via anatomical landmarks under fluoroscopic guidance for ablation to provide longer-lasting relief. Evidence supporting RFA for GTPS remains limited, but this case contributes to the growing body of evidence for its use.
Conclusions: RFA is a promising treatment for patients with GTPS who have not achieved lasting relief from standard therapies. Given the patient’s positive response to prior bursa injections, RFA for the trochanteric bursa may offer a long term solution.
