Keywords:
Musculoskeletal joint, Musculoskeletal soft tissue, Ultrasound, Conventional radiography, Diagnostic procedure, Athletic injuries, Inflammation
Authors:
J. Murphy1, J. yusta-zato2, A. Patel3, A. M. Davies3, S. L. James3, C. McBryde3, R. Botchu3; 1Cork/IE, 2Manchester/UK, 3Birmingham/UK
DOI:
10.26044/ecr2019/C-1094
Methods and materials
Patients with lateral hip pain referred for ultrasound of the hip at our institution between February 2012 and October 2017 were identified using our institutions radiology management system.
Patients referred with lateral hip pain in both a native hip and post THA were included in the study.
Patients with sonographic evidence of subgluteal bursitis,
trochanteric bursitis and gluteal tendinopathy as well those with clinical evidence of trochanteric bursitis whom underwent ultrasound-guided diagnostic injection were included in the study.
Patient demographics were recorded for all patients.
Gluteal tendinopathy was defined as reduced echogenicity and loss of the normal fibrillar pattern in the gluteus medius and/or minimus tendons.
Trochanteric and subgluteal bursitis were defined as fluid in the trochanteric and subgluteal bursae respectively.
Patients referred for bilateral ultrasounds with bilateral symptoms were excluded.
An anteroposterior pelvic radiograph was performed on all patients with the patient supine and both legs internally rotated 15 degrees with the X-ray beam centred on the pubic symphysis with a film focus distance of 115 cm.
Patients without anteroposterior radiograph were excluded from this study.
Femoral offset (FO),
global offset (GO),
abductor lever arm (ALA) and trochanteric impingement distance (TID) were measured in each patient on both the symptomatic and asymptomatic side (figures 1-4).
Measurements on the normal,
asymptomatic side were used as control.
The presence of THA was also recorded.
Statistical analysis was performed using SPSS Statistics (IBM Corp.
Released 2016.
IBM SPSS Statistics for Mac,
Version 24.0.
Armonk,
NY:IBM Corp).
Data were expressed as mean ± standard deviation (SD).
Mean FO,
GO,
ALA and TID were compared between patients with tendinopathy,
subgluteal and trochanteric bursitis and groups using an independent samples t-test.
Interobserver reliability was also calculated for the 4 radiographic measurements using the interclass coefficient.
A p-value of less than 0.05 was considered significant.