Question
Case Study Vignette
A 27-year-old female triathlete presents to your outpatient facility with a chief complaint of left lateral hip pain. She recently began training for an upcoming event after taking a substantial amount of time off from training (approximately 3 months) and drastically increased her training volume. She reports having a history of a left 5th metatarsal stress fracture in high school.
When screening for the presence of a potential femoral stress fracture, she had negative findings on both the Fulcrum and Patellar-Pubic Percussion tests. In spite of these findings, radiology was performed to confirm the absence of fracture/stress fracture. X-ray imaging showed no evidence of fracture, but did show an increased alpha angle, which is indicative of cam femoroacetabular morphology.
When continuing to consider the likelihood of greater trochanter pain syndrome, what is the most likely structure involved?
A. Trochanteric Bursa
B. Gluteal Tendinopathy
C. Gluteal Tendon Tear
D. Thickened Iliotibial Band
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ANSWERS:
A. Trochanteric Bursa
Based on the study performed by Long and colleagues, only 20.2% of patients presented with trochanteric bursitis.
Long SS, Surrey DE, Nazarian LN. Sonography of Greater Trochanteric Pain Syndrome and the Rarity of Primary Bursitis. American Journal of Roentgenology. 2013;201(5):1083-1086. doi:10.2214/AJR.12.10038.
B. Gluteal Tendinopathy (CORRECT ANSWER CHOICE)
Based on the study performed by Long and colleagues, a majority of patients presented with gluteal tendinopathy (49.9%).
Long SS, Surrey DE, Nazarian LN. Sonography of Greater Trochanteric Pain Syndrome and the Rarity of Primary Bursitis. American Journal of Roentgenology. 2013;201(5):1083-1086. doi:10.2214/AJR.12.10038.
C. Gluteal Tendon Tear
Based on the study performed by Long and colleagues, only 0.5% of patients presented with gluteal tendon tear.
Long SS, Surrey DE, Nazarian LN. Sonography of Greater Trochanteric Pain Syndrome and the Rarity of Primary Bursitis. American Journal of Roentgenology. 2013;201(5):1083-1086. doi:10.2214/AJR.12.10038.
D. Thickened Iliotibial Band
Based on the study performed by Long and colleagues, only 28.5% of patients presented with a thickened iliotibial band.
Long SS, Surrey DE, Nazarian LN. Sonography of Greater Trochanteric Pain Syndrome and the Rarity of Primary Bursitis. American Journal of Roentgenology. 2013;201(5):1083-1086. doi:10.2214/AJR.12.10038.
