Excessive fluid release following corticosteriod injection right thigh - is this normal?

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Six weeks ago I underwent an ultrasound guidance injection of bupivacaine and corticosteroid into the region of the right trochanteric bursa. I was informedd that the injection would take 2 - 3 days to "kick in" and "you should be right after about six weeks".....WRONG! The pain in the area of the bursa is worse and I have trouble sleeping. Standing doing housework - cooking, dishes etc - causes shooting pain to thigh and hip. As for walking - 10 metres is the limit! My concern though, is the amount of fluid which was released when the needle was extracted - it literally flooded the surgery bed. Is this a normal reaction to piercing the bursa? I have had four similar injections to my right shoulder AC without the waterworks.

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  • Posted

    It seems that you had a true bursa (or bursa like phenomenon, such as a ganglion).

    True "trochanteric bursitis" is rare. This type of pain is usually caused by an entheseopathy at the gluteal insertion.

    The ultrasound would have demonstrated the existance of this fluid. The radiologist could have injected a small ammount of contrast to demonstrate the origin of the fluid - not to do so was remiss. Was the fluid sent to the path lab?

    I suggest that you talk to that radiologist (assuming it was a radiologist, which it should have been) asking for further clarity.

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    • Posted

      Thank you for that information jp. From memory, I had an initial scan which showed the existance of a fluid sac in the bursa. The ultrasound guidance injection of bupivacaine and corticosteroid was conducted at the the radiologist's. I watched the screen and could see the needle entering the fluid sac (pointed out by the Dr - very kind of him....NOT!) and the bupivacaine and corticosteroid mixture being administered. It appeared as a darker coloured swirling mix. It  was only after the needle was removed that the excessive fluid appeared on my thigh. All the Dr/radiologist did was supply a paper towel to wipe it off. I assumed at that time that everything was normal. It is only since the pain has persisted/increased that I have concerns. As an aside....I had an appointment with my neurosurgeon, and am scheduled for MRI of lower spine L2-L3, for this afternoon.
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    • Posted

      A true trochanteric bursitis is often an expression of rheumatoid arthrosis.

      It might not be wise to confine a lumbar MRI to only two segments, since exact clinical identification of the troublesome segment is dificult.

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    • Posted

      Just to clarify. My referral for MRI is for lumbar spine. The clinical notes reference (R) L2 or L3 pain, ? n. root compression. I do have a disc bulge at L5.
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    • Posted

      The majority of people in Sainsbury's this morning probably have "disc bulges" at L5/S1 without being aware of it.
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