الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Greater trochantric pain syndrome is a clinical condition characterized by pain and tenderness at or around the trochantric area. Enthesopathy, tendinopathy, snapping iliotibial band may be the source of pain. Greater trochantric pain syndrome mainly affect female. The female to male ratio is 4:1. GTPs is diagnosed clinically by presence of pain and tenderness around the trochantric area. The treatment includes conservative methods as activity modification, non-steroidal anti-inflammatory drugs, local injection of corticosteroid with or without anesthetic. Surgical intervention such as bursectomy releasing iliotibial band, hip cuff repair and trochantric reduction osteotomy may be required if symptoms recur and discomfort persists. Extracorporeal shock wave therapy for the treatment of GTPs was based on successful use of radial shock wave therapy for planter fasciitis, Achilis tendinitis and lateral epicondylitis. The aim of this study was to compare the effect of ultrasound guided injection of corticosteroid and extracorporeal shock wave therapy for refractory greater trochantric pain. This prospective randomized study was carried out on 30 patients with greater trochanter pain. The criteria of diagnosing of greater trochanter pain was according to history and physical examination • findings in adults‟ patients of either sex. Patients were randomly divided into 2 equal groups according to line of treatment: • group I: treated by twice injections of 1ml methyl prednisolon combined with 4ml of lidociane 2 weeks apart under ultrasound guidance. • group II: treated by extracorporeal shock wave therapy. 4 sessions one week apart of radial shock wave, 2000 pulses, energy level (2.0-3.0 bar), frequency 12Hz. All patients were subjected to clinical assessment by complete history taking, visual analogue scale, numeric rating scale and Roles and Maudsley score and Functional assessment by Lower extremity functional scale. Summary of our Results: • Demographic data (age and sex), duration of complaint, occupation of patients, side of affection with greater trochantric pain, hypertension and diabetes mellitus, were matched between the two studied groups. • In group I VAS score significantly reduced after both 3 weeks and 3 months of treatment compared to its pretreatment value. VAS score was significantly lower after 3 months compared to it value after 3 weeks. • In group II VAS score significantly reduced after both 3 weeks and 3 months of treatment compared to its pretreatment value. • While there was an insignificant difference in VAS score after 3 weeks and after 3 months of treatment. • VAS score was significantly lower in group I than group II after 3 weeks and after 3 months of treatment (p< 0.05). • In group I NRS significantly reduced after both 3 weeks and 3 months of treatment compared to its pretreatment value. NRS was significantly lower after 3 months compared to its value after 3 weeks. • In group II NRS significantly reduced after both 3 weeks and 3 months of treatment compared to its pretreatment value. While there was an insignificant difference in NRS after 3 weeks and after 3 months of treatment. • NRS was significantly lower in group I than group I after 3 months of treatment (p< 0.05). • In group I excellent improvement in RMS significantly increased after both 3 weeks and 3 months of treatment compared to its pretreatment value. Excellent improvement in RMS was significantly higher after 3 months compared to its value after 3 weeks. • In group II improvement in RMS significantly increased after both 3 weeks and 3 months of treatment compared to its pretreatment value. • Improvement in RMS was significantly higher in group I than group II after 3 months of treatment (p< 0.05). • In group I LEFS significantly increased after both 3 weeks and 3 months of treatment compared to its pretreatment value • .LEFS was significantly higher after 3 months compared to its value after 3 weeks. • In group II LEFS significantly increased after both 3 weeks and 3 months of treatment compared to its pretreatment value. While there was an insignificant difference in LEFS after 3 weeks and after 3 months of treatment. • LEFS was significantly higher in group I than group II after 3 weeks and after 3 months of treatment (p< 0.05).