Disodium clodronate in painful nonresponsive periarthropathy of the hip

This article identifies and describes a small group of patients with trocha nteric tendinitis and bursitis in whom ali modes of traditional therapy fai led. We hypothesized that obstinate pain could be due to an increase in bon e turnover associated with the formation of marginal bony outgrowths or ent hesophytes. Injectable disodium clodronate is known to be highly efficaciou s in inhibiting bone reabsorption and is able to reduce several types of bo ne pain. The aim of the study was to evaluate the effectiveness of disodium clodronate in periarticular pathology of the hip in a group of patients re sistant to traditional treatments and who were hypothesized to have a compo nent of bone pain in their pain syndrome. Periarticular ultrasound examinat ion is a useful method for detecting soft tissue alterations and is of inte rest in the study of these patients. In this study ultrasound examination s howed periarticular alterations even when results of radiography were negat ive. Reduction in the hyperechoic ultrasound image, which confirms periarti cular calcification, was observed in 75% of the patients treated with disod ium clodronate vs. 33% of those treated with paracetamol. At the end of the study, ail patients treated with disodium clodronate had a reduction in sp ontaneous and provoked pain greater than or equal to 1/3 vs, the basal visu al analogue scale, unlike those treated with paracetamol.