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greater trochanteric pain syndrome

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: - meralgia paresthetica - diabetes mellitus, pain & loss of sensation anterolateral thigh 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]

Related

greater trochanter

Specific

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

General

syndrome musculoskeletal disease/disorder

References

  1. Strauss EJ, Nho SJ, Kelly BT. Greater trochanteric pain syndrome. Sports Med Arthrosc. 2010 Jun;18(2):113-9 PMID: 20473130
  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: 32769596
  3. Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. 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: 34158938
  5. NEJM Knowledge+