Does Ultrasound Correlate with Surgical or Histologic Findings in Greater Trochanteric Pain Syndrome? A Pilot Study

Abstract

Background Greater trochanteric pain syndrome can be severely debilitating. Ideal imaging modalities are not established, treatments are not reliably evaluated, and the underlying pathology is not well understood.

The management of greater trochanteric pain syndrome: A systematic literature review

“…The outcome tool also should be shown to be valid for the particular patient population/ condition studied. 40 As there is no specific outcome measurement tool for GTPS, 41 Duplications from the searches were removed which left 879 studies. There was one Cochrane Library paper which was a protocol for a systematic review for interventions for lateral hip pain (tendinopathy or bursitis).…”

Increased substance P expression in the trochanteric bursa of patients with greater trochanteric pain syndrome

“…These participants had tissue collected at the time of surgery for standard pathological screening by a registered pathologist. Details regarding this group's surgery and outcomes have been previously reported [7]. Fourteen control participants with a primary diagnosis of osteoarthritis of the hip undergoing a total hip arthroplasty were recruited.…”

“…Previous studies have been limited by the lack of a comparison group [6][7][8][9]. There remains ongoing speculation about the source of symptoms (tendon vs. bursa) in patients with GTPS [6][7][8][9]. Substance P (SP) has been implicated in the pain and pathology of tendinopathy and bursitis.…”

Greater Trochanteric Pain Syndrome: An Update on Diagnosis and Management

“…Ultrasound can help visualize the gluteal muscle insertions on the greater trochanteric facets to localize pathology, and it has a high positive predictive value (PPV = 1.0) for identifying peritrochanteric abnormalities [10]). Gluteal tendinopathy is characterized by tendon heteroechogenicity, hypertrophy, neovascularization, or abnormal tendon architecture.…”

“…In patients with trochanteric bursitis who had their bursae removed during total hip arthroplasty, histopathological analysis of the bursae demonstrated fibroadipose and fibroconnective tissue with no signs of acute or chronic inflammation or of increased fibrosis [9]. Bursal abnormalities such as increased fluid or thickening occur as reactive or secondary findings to underlying gluteal muscle tendon tear [10]. In an MRI study of 24 patients with GTPS, only 2 had trochanteric bursal distension, whereas 11 had a gluteus medius tear and 9 had gluteus medius tendinitis [7].…”