Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip.

Abstract

We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome. Hip MRA performed at our institution (3/2012-1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40years) and FAI type (cam, pincer, and mixed) was also performed. N=189 patients were included (n=125 males; age 39±12years). FAI was diagnosed in n=133 (70, 4%): cam type, n=85 (63, 9%); pincer type, n=22 (16, 6%); and mixed type, n=26 (19, 5%). N=72 patients (38.1%) had tendinopathy, n=14 (7.4%) had trochanter erosion, n=31 (16.4%) had bursitis, n=4 had bone oedema (2.1%), and n=3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n=74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P=0.023) than that of FAI/GTPS. Under 40years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P=0.028). Over 40years, no difference between patients with/without FAI (P=0.119) was seen. GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.