SA Orthopaedic Journal
On-line version ISSN 2309-8309
Print version ISSN 1681-150X
Greater trochanteric pain syndrome is a common, but often misdiagnosed cause of lateral hip pain. Recent advances in the imaging of the hip has improved the understanding of the causative mechanisms of greater trochanteric pain syndrome (GTPS). The syndrome encompasses a wide spectrum of causes including tendinosis, muscle tears, iliotibial band (ITB) disorders and surrounding soft tissue pathology. Clinically GTPS presents with lateral hip tenderness and pain with resisted abduction. A positive Trendelenburg test is the most sensitive predictor of a gluteal tear. Altered lower limb biomechanics is proposed as an important predisposing factor for gluteal muscle pathology. Many conditions are associated with GTPS: some of them may predispose to GTPS, while others may mimic the symptoms. Although plain radiographs are still important for ruling out other causes of hip pain, MRI has become the imaging modality of choice in GTPS. Most cases of GTPS can be regarded as self-limiting. Conservative modalities (rest, NSAIDs, physiotherapy) are still the mainstay of treatment. Corticosteroid injections are still widely used and reported to be successful. Proven gluteal muscle tears are treated with surgical repair and bursectomy. Endoscopic techniques have become increasingly popular.
Keywords : trochanteric; bursitis; hip; gluteus medius; tendinopathy.