Intended for healthcare professionals

Rapid response to:


Comparison of fluoroscopically guided and blind corticosteroid injections for greater trochanteric pain syndrome: multicentre randomised controlled trial

BMJ 2009; 338 doi: (Published 14 April 2009) Cite this as: BMJ 2009;338:b1088

Rapid Response:

Distinguishing variables

Foundation flaws in this paper are to not recognise (at least) these two variables in the subjects of this research.

1. No distinction between pathologies is made. This is fundamental if any pronouncements of therapeutic efficacy are intended. The paper refers to “gluteal bursitis”. While this undoubtedly occurs, it is rare. Most pain in the trochanteric region is an entheseopathy of the insertion of the great abductors.

2. Differentiating subject obesity. Target accuracy in the lean is not difficult. However in the obese the desirable level of accuracy is impossible without imaging guidance.

Competing interests:
None declared

Competing interests: No competing interests

28 April 2009
Jon P Driver-Jowitt
Orthopaedic surgeon
3 Norfolk Road, Newlands 7700, Cape Town