HIP TENDINOPATHY IN GENERAL MEDICINE

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Clara Selves Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Summary :

Greater trochanteric pain syndrome is a degenerative disorder of the tendons surrounding the greater trochanter, trochanteric bursitis may or may not be present. Sometimes referred to as the "false sciatica", pain may radiate to the knee, but has a mechanic clinical presentation. History taking and clinical examination are key to the diagnosis, revealing painful palpation of the peritrochanteric region. Paraclinical exams should be reserved to unusual clinical presentations.

Treatment consists in physiotherapy, with eccentric reinforcement of the gluteal muscles and shock wave therapy applied to the involved tendons. Corticosteroid infiltrations should be proposed in case of therapeutic failure of physiotherapy. Snapping hips are a benign condition, due to a conflict during the passage of the fascia lata over the greater trochanter (external snap) or during the passage of the psoas muscle over the ilio-pectineal eminence or the small trochanter (anterior snap). The diagnosis should also be clinical, based on a detailed history taking and clinical examination. Patients are often able to reproduce the snapping, which helps to confirm the diagnosis. There is no causal treatment. Patients should be reassured regarding the benign nature of the condition and, in the rare cases when snapping is symptomatic, be proposed with physiotherapy sessions and be advised to avoid sports revealing the snapping.

Key Words

Greater trochanteric pain syndrome, trochanteritis, hip tendinopathy, snapping hip