Patients with iliopsoas tendinopathy complain about anterior hip pain during active hip flexion. This typically occurs while getting out of the car or bed. A treatment option is the iliopsoas bursa injection.
Objectives
To report patient outcomes up to 1 month after fluoroscopy-guided iliopsoas bursa injection for suspected iliopsoas tendinopathy.
Methods
Thirty-nine consecutive patients (mean age 45 years; range 15–77) who underwent fluoroscopy-guided therapeutic iliopsoas bursa injection using an anterolateral approach and who returned an outcomes questionnaire were prospectively included. The Patients’ Global Impression of Change (PGIC) scale was recorded 1 day, 1 week, and 1 month after the injection (primary outcome measure). Patients’ subjective pain level data were collected prior to the injection (baseline) using a numeric rating scale (NRS; 0 = no pain; 10 = maximum pain). NRS scores were completed 15 min, 1 day, 1 week, and 1 month post-injection and compared to baseline.
Results
Forty-nine per cent of patients reported clinically relevant ‘improvement’ (PGIC) 1 month post-injection. Mean NRS score prior to injection was 5.9 ± 2.1. Mean NRS scores after 15 min (3.6 ± 2.7), 1 day (4.4 ± 2.7), 1 week (3.4 ± 1.9), and 1 month (3.5 ± 2.5) were statistically significantly lower (p ≤ 0.001) compared to baseline. Reduction of NRS ≥50 % after 15 min was achieved in 49 % (56 % of those unimproved at 1 month).
Conclusions
Fluoroscopy-guided iliopsoas bursa injection leads to a relevant ‘improvement’ at 1 month or significant pain reduction after 15 min in most patients.
Key points
• Fluoroscopy-guided iliopsoas bursa injection is a safe procedure.
• Most patients had a diagnostic or therapeutic benefit from the injection.
• The anterolateral approach may reduce the risk of damage to the neurovascular bundle.
• The procedure is eligible for patients with and without total hip arthroplasty.
Eur Radiol. 2014 Oct 3: Outcomes after fluoroscopy-guided iliopsoas bursa injection for suspected iliopsoas tendinopathy. Agten CA, Rosskopf AB, Zingg PO, Peterson CK, Pfirrmann CW.