Hip greater trochanteric bursitis
Greater trochanteric pain syndrome (GTPS)
Hip abductor pain syndrome
PREFERRED PRACTICE PATTERN
4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation1
A 15-year-old female soccer player complains of left hip pain. After taking a thorough history, it is noted that formal team conditioning practice started 2 weeks ago and she has been running on the road in the evenings after practice in efforts to get into “shape.” The athlete complains of pain at the beginning of practice that somewhat dissipates during practice but then returns with greater intensity after practice is over. She also mentioned that there is increased pain when she puts more weight on the left leg.
Pain over the greater trochanter, lateral thigh pain2
Differs from hip pointer (iliac crest contusion) based on location of injury/trauma
Pain on transition between standing and lying down
Fall onto lateral hip
Diagnostic ultrasound can detect bursitis verse gluteal tendinosis, gluteal tears and thickening of the ITB tendon
Friction between iliotibial band (ITB), bursa, and trochanter
Pressure from greater trochanter and overlying muscles compress bursa into the trochanter, creating pain and discomfort
Bursa is next to femur, between insertion of the gluteus medius and gluteus minimus
Functions as a shock absorber
The bursae of the hip. (Reproduced with permission from Simon RR, Sherman SC, Koenigsknecht SJ. Emergency Orthopedics, The Extremities. 5th ed. © 2007, McGraw-Hill Inc., New York.)
Lesions of the Hip and Groin. (A) Trendelenburg sign. When the patient stands on one foot, the buttock falls. (B) Subinguinal painless swelling. Swelling below the inguinal ligament may be either a psoas abscess or an effusion in the psoas bursa. (From LeBlond RF, DeGowin RL, Brown DD. DeGowin’s Diagnostic Examination. 9th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
SIGNS AND SYMPTOMS
Audible or palpable snapping over lateral hip3
Point tender with palpation
Radicular pain into buttock, down leg into knee
Limited motion ...
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