Semin Musculoskelet Radiol 2017; 21(05): 539-546
DOI: 10.1055/s-0037-1606139
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Greater Trochanteric Pain Syndrome: Abductors, External Rotators

Anna Hirschmann
Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
,
Anna L. Falkowski
Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
,
Balazs Kovacs
Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
12 October 2017 (online)

Abstract

Chronic pain and tenderness at the greater trochanter characterizes trochanteric pain syndrome. For a long time, trochanteric bursitis was thought to be the only underlying pathology; however, investigations have shown that tendinopathy of the abductors is the main cause, followed by iliotibial band thickening and, to a lesser extent, abductor tendon tears. Trochanteric bursitis can be associated with it. On magnetic resonance imaging (MRI), peritrochanteric T2 abnormalities are evident in greater trochanteric pain syndrome. However, this is also frequently encountered in asymptomatic patients. In the postoperative setting, patients with total hip arthroplasties and transtendinous lateral or posterior surgical access are prone to tendon injury. Symptomatic patients typically present with tendon tears, whereas peritrochanteric fluid, thickening, and signal alterations of the abductors and fatty atrophy of the gluteus minimus muscle are often encountered in asymptomatic postoperative hips. MRI and ultrasound are proven and reliable imaging modalities in patients with greater trochanteric pain syndrome. Awareness of typical imaging findings, in particular in postoperative patients, are helpful in the evaluation of patients.