Greater Trochanteric Pain Syndrome: A Review of Anatomy, Diagnosis and Treatment

Abstract

Greater trochanteric pain syndrome (GTPS) is a term used to describe chronic pain overlying the lateral aspect of the hip. This regional pain syndrome, once described as trochanteric bursitis, often mimics pain generated from other sources, including, but not limited to myofascial pain, degenerative joint disease, and spinal pathology. The incidence of greater trochanteric pain is reported to be approximately 1.8 patients per 1000 per year with the prevalence being higher in women, and patients with coexisting low back pain, osteoarthritis, iliotibial band tenderness, and obesity. Symptoms of GTPS consist of persistent pain in the lateral hip radiating along the lateral aspect of the thigh to the knee and occasionally below the knee and/or buttock. Physical examination reveals point tenderness in the posterolateral area of the greater trochanter. Most cases of GTPS are self-limited with conservative measures, such as physical therapy, weight loss, nonsteroidal antiinflammatory drugs and behavior modification, providing resolution of symptoms. Other treatment modalities include bursa or lateral hip injections performed with corticosteroid and local anesthetic. More invasive surgical interventions have anecdotally been reported to provide pain relief when conservative treatment modalities fail.

Extracorporeal Shockwave Therapy for Refractory Greater Trochanteric Pain Syndrome

“…The mechanism through which of shockwave therapy works for GTPS is not fully understood, but it is thought to work on tendinosis or enthesopathy of the gluteal tendons [1][2][3][4]14]. MRI scanning may help in the diagnosis of GTPS and the selection of patients with tendinosis or enthesopathy for ESWT [14].…”

“…Greater trochanteric pain syndrome (GTPS) is a condition characterized by pain and tenderness at or around the trochanteric area [1,2]. Described originally as trochanteric bursitis, most now prefer to use the term GTPS.…”

“…Described originally as trochanteric bursitis, most now prefer to use the term GTPS. This is because in most cases, no inflammation is detected in the bursa on imaging or surgery, and the source of pain could be enthesopathy, gluteus medius and / or minimus partial tendon tears, or a snapping iliotibial band [1][2][3][4].…”

“…Despite being commoner in people with sedentary life style, it also affects runners and athletes who tend to be younger [1]. The diagnosis is mainly clinical, with pain and tenderness around the trochanteric area [2,3]. Radiographs are required to rule our other pathology.…”

Hip Abductor Tendinopathy: Work-Up and Open Versus Arthroscopic Repair of Hip Abductor

“…It is four times more common in women and is usually seen between the fourth and sixth decades of life [5,6]. Patients with osteoarthritis, iliotibial band tenderness, low back pain, and obesity are at an increased risk [7,8]. Hip abductor tendinopathy falls under a broader classification of greater trochanteric pain syndrome (GTPS).…”