Relationship of the Pelvic-Trochanteric Index with greater trochanteric pain syndrome

Leandro Emílio Nascimento Santos,Túlio Pinho Navarro,Carla Jorge Machado,Henrique Antônio Berwanger De Amorim Cabrita,Robinson Esteves Pires,Leonardo Brandão Figueiredo,Henrique Melo Campos Gurgel,Rudolf Moreira Pfeilsticker,Helvécio Grandinetti,Amanda Damasceno De Souza,Marco Antônio Percope De Andrade

doi:10.6061/clinics/2021/e3312

Leandro Emílio Nascimento Santos, Túlio Pinho Navarro + Show 9 more

Open Access

https://doi.org/10.6061/clinics/2021/e3312

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Journal: Clinics	Publication Date: Jan 1, 2021
Citations: 2	License type: cc-by

Affiliation: Universidade Federal de Minas Gerais

Abstract

OBJECTIVES:This study aimed to correlate a higher Pelvic-Trochanteric Index (PTI) with an increased varus of the femoral neck with greater trochanteric pain syndrome (GTPS). The secondary objective was to check whether the pelvic width changes with age.METHODS:A prospective study was conducted to compare female patients diagnosed with GTPS (case group) with asymptomatic female participants (control group) from March 2011 to June 2017. On an anteroposterior pelvic radiograph, lines were drawn by two radiologists, and the PTI (ratio of the distance between the greater trochanters and distance between the iliac crests) was defined and the femoral neck-shaft angle was measured.RESULTS:Data collected based on radiographs of 182 female patients (cases) and 150 female participants (controls) showed that the mean PTI was 1.09 (SD=0.01) in the case group and 1.07 (SD=0.01) in the control group (p<0.05), regardless of age. The distance between iliac crests increased with age (p<0.05) in symptomatic and asymptomatic individuals. It was also found that the mean femoral neck-shaft angle was 130.6° (SD=0.59) and progression of the varus angulation occurred with age in both groups, with a significance level of 5%.CONCLUSIONS:The PTI was higher in patients with GTPS. The femoral neck-shaft angle does not differ between individuals with and without GTPS; however, it does decrease with age. The pelvic width tends to increase with aging in symptomatic or asymptomatic individuals; therefore, the increase in the pelvic width and decrease in the femoral neck-shaft angle can be interpreted as normal in aging women, which could alter the biomechanics of the hips and pelvis.

Highlights

Greater trochanteric pain syndrome (GTPS) or lateral peritrochanteric syndrome of the hip includes trochanteric bursitis, external snapping hip, and gluteus medius and minimus tendinopathies and tears [1]
The agreement rate between the radiologists was 96.1% (49/51) in radiographic Pelvic–Trochanteric Index (PTI) measurements (Table 1), which was higher than the agreement that would occur at random
The present study showed a positive association between age and increase in the iliac crest distance in both groups, which agrees with the reports of Berger et al [21] who found that the pelvis and the L4 vertebra had their width increased after skeletal maturity in both sexes

Summary

Introduction

Greater trochanteric pain syndrome (GTPS) or lateral peritrochanteric syndrome of the hip includes trochanteric bursitis, external snapping hip, and gluteus medius and minimus tendinopathies and tears [1]. Symptoms of GTPS include pain exacerbated while walking or lying on the symptomatic side, sometimes radiating distally to the thigh, proximal iliotibial band pain [2], and snapping over the greater trochanter. The prevalence of GTPS is 10%–20% in the general population, with an incidence of 1.8 per 1,000 people Received for publication on July 8, 2021. Accepted for publication on September 16, 2021

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