greater trochanteric pain syndrome
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Introduction
disorders of the lateral, peritrochanteric space of the hip
Etiology
- gluteus medius & gluteus minimus tendinopathy, with or without trochanteric bursitis[2]
- trochanteric bursitis
- gluteus medius tear
- gluteus minimus tear
- external coxa saltans (snapping hip)
- risk factors[5]
- 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[3]
- 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
Management
- no treatment is predictably effective
- self-limited disorder in many patients[5]
- physical therapy
- acetaminophen, NSAIDs
- extracorporeal shockwave therapy may benefit some patients*[2]
- treat as trochanteric bursitis[5]
* treatment not recognized by ref[5]
More general terms
More specific terms
- coxa saltans; snapping hip; iliopsoas tendonitis; dancer's hip
- gluteal tendonitis
- trochanteric bursitis
Additional terms
References
- ↑ Strauss EJ, Nho SJ, Kelly BT. Greater trochanteric pain syndrome. Sports Med Arthrosc. 2010 Jun;18(2):113-9 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20473130
- ↑ 2.0 2.1 2.2 Ramon S et al. Focused shockwave treatment for greater trochanteric pain syndrome: A multicenter, randomized, controlled clinical trial. J Bone Joint Surg Am 2020 Aug 5; 102:1305. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32769596
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
- ↑ Pianka MA, Serino J, DeFroda SF, et al. Greater trochanteric pain syndrome: Evaluation and management of a wide spectrum of pathology. SAGE Open Med. 2021;9:20503121211022582. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34158938
- ↑ 5.0 5.1 5.2 5.3 5.4 NEJM Knowledge+