Assessment of ultrasound imaging and physical examination findings in greater trochanteric pain syndrome

Year 2015, Volume: 42 Issue: 1, 18 - 21, 09.05.2015

Fulya Bakılan , Gökhan Yüce Ahmet Bicen Kadir Yalçın Gökçe Tanyeri

https://doi.org/10.5798/diclemedj.0921.2015.01.0523

Cited By: 1

Abstract

Objective: The aim of this study was to investigate the prevalence of greater trochanteric bursitis and gluteus medius tendinopathy using ultrasound in patients with greater trochanteric pain and assess the value of the pain on resisted hip abduction and pain on resisted hip internal rotation in predicting the presence of gluteus medius tendinopathy. Methods: The study was a retrospective analysis of 75 patients with greater trochanteric pain. The physical examination records were identified as pain on resisted hip abduction and hip internal rotation. After observing physical examination records, presence of greater trochanteric bursitis or gluteus medius tendinopathy were assessed in documented ultrasound findings. Results: Of the 75 patients with greater trochanteric pain, trochanteric bursitis was found in 41.4% of patients, gluteus medius tendinopathy was found in 20% of patients. A significant difference was found in both presence of pain on resisted hip abduction and internal rotation between patients with gluteus medius tendinopathy and patients with other abnormalities in favor of gluteus medius tendinopathy. Conclusion: In order to determine the etiology of greater trochanteric pain, physical examination and ultrasound imaging is important, especially examination of pain on resisted hip abduction and hip internal rotation is essential to detect gluteus medius tendinopathy. Key words: Bursitis, gluteus medius tendinopathy, greater trochanteric pain syndrome

Keywords

Bursitis, gluteus medius tendinopathy, greater trochanteric pain syndrome

Büyük trokanterik ağrı sendromunda ultrasonografi ve fizik muayene bulgularının değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, büyük trokanter bölgesinde ağrısı olan hastalardaki trokanterik bursit ve gluteus medius tendinopati prevelansını ultrasonografi kullanarak belirlemek ve gluteus medius tendinopatisi tanısının konulmasında, dirençli kalça abduksiyonu ve iç rotasyonunda ağrı varlığının değerlendirilmesinin önemini belirlemektir.Yöntemler: Bu çalışma büyük trokanterde ağrısı olan 75 hasta üzerinde retrospektif analiz ile gerçekleştirilmiştir. Hastaların fizik muayene kayıtlarında dirençli kalça abduksiyon ve iç rotasyonda ağrı varlığı araştırılmıştır. Fizik muayene kayıtlarının analizinden sonra hastaların kas iskelet sistemi ultrasonografi görüntüleme kayıtları incelenmiş olup, trokanterik bursit ve gluteus medius tendinopati varlığı değerlendirilmiştir.Bulgular: Büyük trokanterde ağrısı olan 75 hastanın; %41,4’ünde trokanterik bursit, %20’sinde gluteus medius tendinopatisi saptanmıştır. Dirençli kalça abduksiyonu ve iç rotasyonunda ağrı varlığı, gluteus mediusta tendinopati saptanan ve saptanmayan hastalarda gluteus mediusta tendinopati lehine, istatistiksel olarak belirgin farklı bulunmuştur.Sonuç: Hastalarda büyük trokanter ağrısının etyolojisinin aydınlatabilmesinde fizik muayene ve ultrasonografi ile görüntüleme önemlidir, özellikle dirençli kalça abduksiyonu ve iç rotasyonunda ağrı varlığının değerlendirilmesi, gluteus mediusta tendinopati varlığının saptanmasında gereklidir

Keywords

Bursit, Büyük trokanterik ağrı sendromu, Gluteus medius tendinopatisi

References

• Walsh G, Archibald CG. MRI in greater trochanteric pain
• syndrome. Australas Radiol 2003;47:85-87.
• Bard H, Vuillemin-Bodaghi V, Mutschler C. Tendinopathies
• du moyen et du petit glutéal: étude pilote de critères cliniques.
• Rev Rhum Ed Fr 2006;73:552.
• Tortolani PJ, Carbone JJ, Quartararo LG. Greater trochanteric
• pain syndrome in patients referred to orthopedic spine
• specialists. Spine J 2002;2:251-254.
• Gottschalk F, Kourosh S, Leveau B. The functional anatomy
• of tensor fasciae latae and gluteus medius and minimus. J
• Anat 1989;166:179-189.
• Kagan A 2nd. Rotator cuff tears of the hip. Clin Orthop Relat
• Res 1999;368:135-140.
• Collée G, Dukmans BAC, Vandenbroucke JP. Greater trochanteric
• pain syndrome (trochanteric bursitis) in low back
• pain. Scand J Rheumatol 1991;20:262-266.
• Adler RS, Sofka CM. Percutaneous ultrasound guided injections
• in the musculoskeletal system. Ultrasound Q
• ;19:3-12.
• Weidner S, Kellner W, Kellner H. Interventional radiology
• and the musculoskeletal system. Best Pract Res Clin Rheumatol
• ;18:945-956.
• Connell DA, Bass C, Sykes CA, et al. Sonographic evaluation
• of gluteus medius and minimus tendinopathy. Eur Radiol
• ;13:1339-1347.
• Segal NA, Felson DT, Torner JC, et al. Greater trochanteric
• pain syndrome: epidemiology and associated factors. Arch
• Phys Med Rehabil 2007;88:988-992.
• Ege Rasmussen KJ, Fanø N. Trochanteric bursitis: treatment
• by corticosteroid injection. Scand J Rheumatol
• ;14:417-420.
• Bird PA, Oakley SP, Shnier R, Kirkham BW. Prospective
• Evaluation of Magnetic Resonance Imaging and Physical
• Examination Findings in Patients With Greater Trochanteric
• Pain Syndrome. Arthritis & Rheum 2001;44:2138-2145.
• Kong A, Van der Vliet A, Zadow S. MRI and US of gluteal
• tendinopathy in greater trochanteric pain syndrome. Eur
• Radiol 2007;17:1772-1783.
• Garcia FL, Picado CH, Nogueira-Barbosa MH. Sonographic
• evaluation of the abductor mechanism after total hip arthroplasty.
• J Ultrasound Med 2010;29:465-471.
• Fearon AM, Scarvell JM, Cook JL, Smith PN. Does ultrasound
• correlate with surgical or histologic findings in greater
• trochanteric pain syndrome? A pilot study. Clin Orthop
• Relat Res 2010;468:1838-1844.
• Long SS, Surrey DE, Nazarian LN. Sonography of Greater
• Trochanteric Pain Syndrome and the Rarity of Primary Bursitis.
• AJR 2013;201:1083-1086.
• Blankenbaker DG, Ullrick SR, Davis KW, et al. Correlation
• of MRI findings with clinical findings of trochanteric pain
• syndrome. Skeletal Radiol 2008;37:903-909.