greater trochanteric pain syndrome

Introduction

disorders of the lateral, peritrochanteric space of the hip

Etiology

• gluteus medius & gluteus minimus tendinopathy, with or without trochanteric bursitis
• trochanteric bursitis
• gluteus medius tear
• gluteus minimus tear
• external coxa saltans (snapping hip)
• risk factors
  • obesity
  • iliotibial band syndrome
  • leg length difference
  • plantar fasciitis

Epidemiology

• relatively common, affects 10-25% of the general population

Clinical manifestations

• pain & tenderness in the region of the greater trochanter, buttock, or lateral thigh
  • patient may be able to point with one finger to the area of tenderness
• full range of motion at hip except painful resisted abduction
• symptoms may worsen with walking or prolonged standing
• straight leg raise test is negative
• deep tendon reflexes are normal
• lateral hip pain with FABER test
• see trochanteric bursitis

Differential diagnosis

• meralgia paresthetica
  • diabetes mellitus, pain & loss of sensation anterolateral thigh
• osteoarthritis of the hip
  • generally presents with anterior hip pain or groin pain
  • difficulty putting on shoes & socks

Management

• no treatment is predictably effective
  • self-limited disorder in many patients
• physical therapy
• acetaminophen, NSAIDs
• extracorporeal shockwave therapy may benefit some patients*
• treat as trochanteric bursitis
• autologous platelet-rich plasma injection without benefit for pain or function

* treatment not recognized by ref

More general terms

• syndrome
• musculoskeletal disease/disorder

More specific terms

• coxa saltans; snapping hip; iliopsoas tendonitis; dancer's hip
• gluteal tendonitis
• trochanteric bursitis

Additional terms

• greater trochanter