Diagnosing Greater trochanteric pain syndrome

This refers to pain over the lateral aspect of the thigh, it is classified as a syndrome as it is used as an umbrella term to cover conditions such as gluteal tendinopathy, trochanteric bursitis or external coxa saltans. This syndrome is more common in people in the 40-60 age group, more so in women due to their pelvis structure and is also associated with obesity. The exact cause is often unknown and can be attributed to a variety of factors such as muscle overuse, improper healing, hip joint anatomy.

SYMPTOMS

Patients with GTPS usually present with pain on standing for long, when sleeping on either side, sitting on low surfaces and crossing their legs whilst sitting. Pain can present over the lateral and posterior aspect of the thigh; the pain is often worse at rest as it has inflammatory type symptoms. It can also increase with walking. Most patients report lateral hip pain after they started walking more or going to the gym or increased the intensity of their workouts.

DIAGNOSTIC TESTS.

Special tests can be used to discern and isolate pain symptoms and help guide the diagnosis after taking a good subjective assessment. A battery of test are used to isolate pain symptoms from other differentials. Tests such as:-

1) Single leg standing test

2) FADDER

3) FABER

4) Resisted Abduction in modified Obers position.

5) Pain or discomfort on either one of these pain provocation tests along with positive test for tenderness/pain on palpation of greater trochanter can be indicative of GTPS. Pain can also present over the iliac crest and can indicate TFL involvement