Presented at the 2012 AAPM Annual Meeting « Back

Ultrasound-Guided Injections for Ischial Bursitis

Anne M. McKenzie-Brown, MD, amckenz@emory.edu¹, Armin Oskouei, MD², Douglas J. Freiberger, MD³, Gonzalo Gonzales, DO³, (1) Emory University Department of Anesthesiology, Atlanta, Georgia, (2) Emory University School of Medicine, Atlanta, Georgia, (3) Emory University, Atlanta, Georgia

Introduction: Ischial Bursitis is an often overlooked cause of buttock pain.¹ We present a new method of injecting the ischial bursa using ultrasound. Methods: Four patients presented to the pain center with buttock pain. Ischial bursitis was diagnosed using a combination of physical examination and ultrasound verification of the pain location at the ischial bursa. In two patients, bilateral ischial tuberosities were scanned under ultrasound for comparison. In both instances the painful side appeared degenerated in comparison to the non-painful side. In each case the ischial bursa was injected with a combination of local anesthetic and steroid under ultrasound guidance. Each patient had relief of their pain within 5 minutes of the injection. There was no paresthesia or leg weakness in any of the patients injected. Conclusion: The use of ultrasound to diagnose Ischial Bursitis has been previously described in the radiology literature.¹ Injecting the ischial bursa using fluoroscopy has also been described, however, that method still risks sciatic nerve injury as only bone can be visualized.² Ultrasound-guided ischial bursa injections have the benefit of direct visualization of the bursa and avoidance of the sciatic nerve. References: 1)Kim AM, Shin MJ, Kim KS et al. Imaging Features of Ishcial Bursitis with an Emphasis on Ultrasonography. Skeletal Radiology 2002;31:631-636 2)Robinson ME, Monfared HH, Ness TJ. A Novel Technique: Fluoroscopic Guided Injection of the Ischial Bursa. Presented at ASRA 2010 Fall Meeting, Phoenix AZ.

Funding: None