Greater trochanteric pain syndroom

Greater trochanteric pain syndrome (GTPS) includes a number of disorders of the lateral peritrochanteric space of the hip such as tears of the gluteus medius and minimus, trochanteric bursitis, and external coxa saltans.

The main clinical symptoms are pain and reproducible tenderness in the region of the greater trochanter and/or the buttock or lateral thigh. Diagnosis is based on the clinical features of the disease. Diagnostic imaging should be considered to rule out other causes of hip pain or to establish the diagnosis of GTPS when in doubt.

Therapy of symptomatic tendon tears comprises rest, antiinflammatory medications and physiotherapy focusing on range of motion and strengthening exercises. Trochanteric bursitis is usually self-limiting and responds to rest, ice, antiinflammatory medications and physiotherapy focusing on stretching, flexibility, strengthening and gait mechanics. When symptoms persist despite these interventions, bursal injections of local anesthetics and corticosteroid can provide effective pain relief.

Radial shock wave therapy (RSWT) has been demonstrated to be efficient for recalcitrant GTPS. In case of inefficacy of RSWT, surgical intervention may be considered in cases in which other potential sources of the patient’s symptoms have been ruled out.