We report a case of calcific tendinopathy of the gluteus medius initially misdiagnosed as a lumbar herniated intervertebral disc. It was successfully treated with barbotage under ultrasonographic guidance finally. A 56-year-old woman was referred to interventional pain clinic for right hip pain due to an L5-S1 disc herniation. Serial L5 and S1 spinal nerve root blocks and epidural steroid injections were administered. However, pain relief was sustained only for a very short period. Plain radiography of the right hip revealed a solid calcific nodule at adjacent to the insertion site of the gluteus medius tendon. Physical modalities and extracorporeal shock wave therapy failed to improve the pain. Therefore, we attempted ultrasound-guided barbotage of the calcification. Barbotage was performed twice serially and her pain was considerably improved. At 6-month follow-up, the calcification was completely resolved.
Citations
Neurostenalgia is a neuropathic pain that results from continuing irritation of an anatomically intact nerve by a noxious agent. The pain resolves promptly after surgical release of the nerve. The authors report a case of neurostenalgia of the radial nerve in which the posterior interosseous branch was compressed at the arcade of Frohse, presenting with severe arm and elbow pain. The pain was immediately relieved after surgical release of the nerve.
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