A Target Crosshair Method for Fluoroscopic-Guided Greater Trochanteric Bursa Injections

Trochanteric bursitis is one of the most common causes of lateral hip pain. Although fluoroscopic-guided greater trochanteric bursa injections (FGTBIs) are commonly performed, literature describing techniques and methods focused on accuracy and precision is scarce.

In this case report, we describe an innovative target crosshair method (TCM) to help improve FGTBI procedural accuracy and precision under fluoroscopic guidance.

The design of this study is a retrospective chart review in the form of a technical methodology report.

This study was completed at a large tertiary academic medical center.

The TCM utilizes anteroposterior (AP) and lateral fluoroscopic views of the proximal femur in order to draw a vertical line (AP) at the level of the junction of the femoral neck, trochanteric fossa, and greater trochanter (GT), and a horizontal line (craniocaudal) along the lateral hip designating the posterior half of the GT.

Three patients with body mass indexes ranging from 35-40 successfully underwent FGTBI using the TCM for greater trochanteric syndrome causing lateral hip pain. All patients experienced > 70% analgesic relief for 4 to 6 months. There were no adverse events reported by any of the patients.

The limitations of this study include the inability to generalize results due to a small sample size and the inherent nature of the study design as a retrospective chart review. The primary intention of this study is to describe a novel technical method.

The TCM results in an accurate path for skin and subcutaneous tissue local anesthetic injection and a final needle tip landing site for corticosteroid injection regardless of patient body habitus.