Greater trochanteric pain syndrome (GTPS) is defined as localised lateral hip pain with focal point tenderness to palpation over the greater trochanter with the patient in the side-lying position (1,2).
GTPS has for many years been clinically diagnosed as trochanteric bursitis. However several features have been observed which lead to a conclusion that the diagnosis of trochanteric bursitis may be inappropriate (1).
- three of the four cardinal signs of inflammation: calor, rubor, and oedema are uncommon in GTPS and only pain is a feature
- advanced imaging and surgical findings in patients with localised lateral hip pain have reported the following disorders with no real bursal involvement
- incomplete tearing or avulsion of the anterior aspect of the gluteus medius and gluteus minimus tendons
- external coxa saltans (snapping hip)
- radiological findings for patients with GTPS report variable incidence, with bursitis incidence ranging from 4% to 46% and gluteal tendinopathy ranging from 18% to 50% (1,2,3)
For these reasons, clinical condition involving pain at or around the greater trochanter has been known by the vaguer term 'greater trochanteric pain syndrome' (GTP) (1).
Predisposing factors include: abnormal hip biomechanics due to abnormal force vectors acting across the hip, age, gender, ipsilateral iliotibial band (ITB) pain, knee osteoarthritis, obesity, low back pain and specific sporting activities (3)
- (1) Reid D. The management of greater trochanteric pain syndrome: A systematic literature review. Journal of Orthopaedics. 2016;13(1):15-28.
- (2) Del Buono A et al. Management of the greater trochanteric pain syndrome: a systematic review. Br Med Bull. 2012;102:115-31.
- (3) Klauser AS et al. Greater trochanteric pain syndrome. Semin Musculoskelet Radiol. 2013;17(1):43-8.
Last edited 04/2018