Learning objectives
To present a clinical entity (GTPS) of high prevalence in our society,
from a multidisciplinary point of view,
addressing its anatomy,
its varied clinical presentation and the importance of imaging methods in its correct management.
Know the outstanding role of hip arthroscopy in the current management of it
Background
GTPS is a regional pain syndrome that is characterized by chronic pain of the lateral hip area,
involving the greater trochanter,
buttock and lateral thigh.
Clinically it presents with tenderness on palpation of the greater trochanter area with the patient in the side-lying position.
Absence of generalized myofascial tenderness to palpation is needed.
HISTORICAL EVOLUTION
Stegemann (1923) Trochanteric bursitis
Leonard (1958) Trochanteric syndrome
Gordon 1961).
Gluteal tendinopathy
EPIDEMIOLOGY
GTPS affects between 10% and 25% of people living in industrialized countries,
with a lifetime incidence of...
Findings and procedure details
CRITERIA FOR DIAGNOSIS OF GREAT TROCHANTERIC PAIN SYNDROME.
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Pinpoint tenderness over the greater trochanter area is the hallmark physical finding in all symptomatic patients.
Tenderness may extend into the lower buttock and lateral thigh but not to a significant degree.
While the patient is standing,
palpate the lateral hip area in a cephalic direction beginning below the greater trochanter eminence until the area of maximal tenderness is identified (“jump sign”) (Fig 8 )
CLINICAL TESTS UTILIZED IN EVALUATION OF LATERAL HIP PAIN
There is...
Conclusion
GTPS is underestimated and underdiagnosed,
resulting in a chronic undertreatment of these patients,
not to forget the social and economic fallout that comes with chronic pain and limitation of mobility.
The role of different imaging techniques in their management is discussed,
given that there is a superposition between symptomatic and asymptomatic patients.
Surgical treatment is reserved for those patients in whom the different preserved therapies used have failed.
In this subgroup the role of MRI is relevant.
References
We expose below the most relevant articles when preparing this poster.
The remaining articles are shown as accessory figures.
Fig. 25 Fig. 26 Fig. 27 Fig. 28
Segal NA,
Felson DT,
Torner JC,
Zhu Y,
Curtis JR,
Niu J,
et al.
Greater trochanteric pain syndrome: epidemiology and associated factors.
Arch Phys Med Rehabil 2007;88(8):988-92.
Williams BS,
Cohen SP.
Greater trochanteric pain syndrome: a review of anatomy,
diagnosis and treatment.
Anesth Analg 2009;108(5):1662-70..
Kong A,
Van d,
V,
Zadow S.
MRI and US of gluteal tendinopathy...