Abstract
Greater trochanteric pain syndrome (GTPS) is a common cause of lower extremity pain. This is frequently attributed to trochanteric bursitis and distension of the subgluteal bursae. Patients are suffering from pain radiating to the posterolateral aspect of the thigh, paraesthesiae in the legs, and tenderness over the iliotibial tract. Often the symptoms are mild, with the patient treating himself successfully through activity modification and other conservative measures. including relative rest, ice, compression, elevation, anti-inflammatory medication and treatment modalities such as ultrasound and electrical stimulation, combined with a structured rehabilitation program. Patients whose symptoms persist despite conservative therapy are likely to benefit from an injection of corticosteroid and anaesthetic into the inflamed bursa. More invasive surgical interventions have anecdotally been reported to provide pain relief when previous treatment modalities fail. In this article, we review the pathogenesis, common initial symptoms, diagnostic approach, and treatment options for trochanteric bursitis.
Highlights
More than 50 years ago, Leonard proposed using the phrase “trochanteric syndrome” to refer to symptoms in the vicinity of the trochanter major [1]
We review the pathogenesis, common initial symptoms, diagnostic approach, and treatment options for trochanteric bursitis
Today Greater trochanteric pain syndrome (GTPS), known as trochanteric bursitis, is defined as tenderness to palpation over the greater trochanter with the patient in the sidelying position [2,3]
Summary
More than 50 years ago, Leonard proposed using the phrase “trochanteric syndrome” to refer to symptoms in the vicinity of the trochanter major [1]. Today Greater trochanteric pain syndrome (GTPS), known as trochanteric bursitis, is defined as tenderness to palpation over the greater trochanter with the patient in the sidelying position [2,3]. Obesity Ipsilateral and/or contralateral hip arthritis Radiculopathy or other neurologic sequelae Repetitive activity Acute trauma Rheumatoid arthritis Chronic mechanical low-back pain Leg length discrepancy Lateral hip surgery Lumbar spine degenerative osteoarthritis Lumber spine degenerative disk disease Post surgical lumbar disk disease Fibromyalgia Iliotibial band (snapping hip) syndrome Total hip arthroplasty Lower limb amputation inflammation and tears of either the gluteus medius or minimus muscles, or their tendinous insertions, from tension imposed by the ITB and/or frictional trauma from overuse, may result in GTPS [18].
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