Gluteal Tendinopathy: Difference between revisions
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Greater trochanteric pain syndrome (GTPS) constitute a large number of musculoskeletal related presentations at the physicianās office. GTPS is an umbrella term encompassing different clinical entities that may contribute to chronic intermittent lateral hip pain. Multiple labels such as ātrochanteric bursitisā and ātronchanteritisā have been used in the past which is now regarded as a misnomer. Invariably, the inflamed or enlarged bursa due to friction (sub-gluteal minimus/medius) is secondary or co-exist with an underlying pathology.Ā Gluteal tendinopathy is identified as one of the major culprits of GTPS along with iliotibial band (ITB) and tensor fascia lata (TFT) as potential causes. Ā | Greater trochanteric pain syndrome (GTPS) constitute a large number of musculoskeletal related presentations at the physicianās office. GTPS is an umbrella term encompassing different clinical entities that may contribute to chronic intermittent lateral hip pain. Multiple labels such as ātrochanteric bursitisā and ātronchanteritisā have been used in the past which is now regarded as a misnomer. Invariably, the inflamed or enlarged bursa due to friction (sub-gluteal minimus/medius) is secondary or co-exist with an underlying pathology.Ā Gluteal tendinopathy is identified as one of the major culprits of GTPS along with iliotibial band (ITB) and tensor fascia lata (TFT) as potential causes. Ā | ||
==Aetiology and Pathophysiology == | ==Aetiology and <u>Pathophysiology</u> == | ||
Gluteal tendinopathy is caused by exposure to load that the tendon did not have adequate adaption or recovery time in order manage.Ā | |||
Ā | |||
==Epidemiology and Risk Factors== | ==Epidemiology and Risk Factors== | ||
Gluteal tendinopathy has a propensity for middle-aged women, between 40 and 60 years. | Gluteal tendinopathy has a propensity for middle-aged women, between 40 and 60 years. | ||
Revision as of 12:13, 3 April 2022
Greater trochanteric pain syndrome (GTPS) constitute a large number of musculoskeletal related presentations at the physicianās office. GTPS is an umbrella term encompassing different clinical entities that may contribute to chronic intermittent lateral hip pain. Multiple labels such as ātrochanteric bursitisā and ātronchanteritisā have been used in the past which is now regarded as a misnomer. Invariably, the inflamed or enlarged bursa due to friction (sub-gluteal minimus/medius) is secondary or co-exist with an underlying pathology. Gluteal tendinopathy is identified as one of the major culprits of GTPS along with iliotibial band (ITB) and tensor fascia lata (TFT) as potential causes.
Aetiology and Pathophysiology
Gluteal tendinopathy is caused by exposure to load that the tendon did not have adequate adaption or recovery time in order manage.
Epidemiology and Risk Factors
Gluteal tendinopathy has a propensity for middle-aged women, between 40 and 60 years.
Clinical Features
Pain tends to be localized to the bony greater trochanter with aggravating activities such as walking, stair climbing and lying on the affected side.
History
Examination
Investigations
MRI and ultrasound are useful Imaging tools to evaluate abnormalities of the lateral hip.
Imaging Findings
Other Investigations
Diagnosis
Differential Diagnosis
Treatment
Acute cases (<3 months) tend to be responsive to conservative measures such as physiotherapy, strengthening exercises, acupuncture, shock-wave therapy, corticosteroid injections and NSAIDs.[1]
Ultrasound can be used for needle guidance. The injectate is deposited directly on the bone and around the injections or into the tendon itself.
CSI may provide benefit in the short term but with a high recurrence rate and poorer results in the long term. Given the paucity of treatments for chronic gluteal tendinopathy (>3 months) and transient amelioration effect of CSI, there is interest whether biologic products such as PRP may provide better long-term outcomes for this condition[2]
The use of PRP has been controversial, especially in tendinopathies given its slower onset of action to see its efficacy. Some tendons respond differently to PRP. Technician skills, type on condition being treated and type of PRP used are all variables that can affect its effectiveness.
Activity Modification
Avoid compression.
Exercise
Leap Trial
Surgery
Gluteal tendon reconstruction is experimental with no standardised techniques.[1]
Follow Up and Prognosis
Large number of patients fail non-operative treatment with significant levels of dysfunction making important to find novel treatment strategies.
Summary
Downloads
Links
How physiotherapists treat gluteal tendinopathy by Dr Alison Grimaldi
References
- ā 1.0 1.1 Koulischer, Simon; Callewier, Antoine; Zorman, David (June 2017). "Management of greater trochanteric pain syndrome : a systematic review". Acta Orthopaedica Belgica. 83 (2): 205ā214. ISSN 0001-6462. PMID 30399983.
- ā Fitzpatrick, Jane; Bulsara, Max K.; OāDonnell, John; Zheng, Ming Hao (April 2019). "Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up". The American Journal of Sports Medicine (in English). 47 (5): 1130ā1137. doi:10.1177/0363546519826969. ISSN 0363-5465.
Literature Review
Literature Review
- Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf
- Articles from all years: PubMed search, Google Scholar search.
- TRIP Database: clinical publications about evidence-based medicine.
- Other Wikis: Radiopaedia, Wikipedia Search, Wikipedia I Feel Lucky, Orthobullets,
