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Greater trochanteric pain syndrome (GTPS), a form of bursitis, is inflammation of the trochanteric bursa, a part of the hip. This bursa is at the top, outer side of the femur, between the insertion of the gluteus medius and gluteus minimus muscles into the greater trochanter of the femur and the femoral shaft. It has the function, in common ...
The more common lateral extra-articular type of snapping hip syndrome occurs when the iliotibial band, tensor fasciae latae, or gluteus medius tendon slides back and forth across the greater trochanter. This normal action becomes a snapping hip syndrome when one of these connective tissue bands thickens and catches with motion.
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Patients also frequently report persistent or intermittent pain or dysthesias in posterior hip, buttocks, or thigh. [4] Unlike discogenic sciatica (caused by the spine), patients with deep gluteal syndrome report exacerbation of symptoms with pressure in the buttocks, such as tenderness or pain on deep palpation, or pain on prolonged sitting.
Causes of pain around the hip joint may be intra-articular, extra-articular, or referred pain from neighboring structures, such as sacroiliac joint, spine, symphysis pubis, or the inguinal canal. [1] Common etiologies include: Trochanteric bursitis, caused by inflammation of the trochanteric bursa of the outer hip, often affecting both hips
Gandbhir and Rayi point out that the biomechanical action involved comprises a class 3 lever, where the lower limb's weight is the load, the hip joint is the fulcrum, and the lateral glutei, which attach to the antero-lateral surface of the greater trochanter of the femur, provide the effort.
In early skeletal development, a common physis serves the greater trochanter and the capital femoral epiphysis. This physis divides as growth continues in a balance that favors the capital epiphysis and creates a normal neck shaft angle (angle between the femoral shaft and the neck). The corresponding angle at maturity is 135 ± 7 degrees.
Greater trochanteric avulsion. Fracture, (or non-union) of the femoral neck. Coxa Vara (the angle between the femoral neck head and shaft is less than 120 degrees). Damage to the hip joint (fulcrum) - Chronic or Developmental Hip Dislocation/Dysplasia Osteonecrosis. Legg-Calve-Perthes disease. Developmental dysplasia. Chronic infection.