Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip

Radiol Med. 2017 Mar;122(3):208-214. doi: 10.1007/s11547-016-0716-4. Epub 2016 Dec 9.

Abstract

Objectives: We evaluated the incidence of greater trochanter pain syndrome (GTPS) in patients who underwent magnetic resonance arthrography (MRA) of the hip for a suspected femoroacetabular impingement (FAI) syndrome.

Methods: Hip MRA performed at our institution (3/2012-1/2014) were reviewed. The absence/presence of FAI (cam, pincer, and mixed) was noted. GTPS diagnosis was based on gluteus medius/minimus tendinopathy/tears, trochanteric bursitis, fascia lata thickening, and trochanter bone oedema/erosion. Subgroup analysis for age (under/over 40 years) and FAI type (cam, pincer, and mixed) was also performed.

Results: N = 189 patients were included (n = 125 males; age 39 ± 12 years). FAI was diagnosed in n = 133 (70, 4%): cam type, n = 85 (63, 9%); pincer type, n = 22 (16, 6%); and mixed type, n = 26 (19, 5%). N = 72 patients (38.1%) had tendinopathy, n = 14 (7.4%) had trochanter erosion, n = 31 (16.4%) had bursitis, n = 4 had bone oedema (2.1%), and n = 3 (1.6%) had fascia lata thickening, resulting in GTPS diagnosis in n = 74 patients (39.2%). The association of normal hip morphology/GTPS was significantly higher (P = 0.023) than that of FAI/GTPS. Under 40 years, GTPS incidence was higher in patients with normal hip and pincer-type FAI (P = 0.028). Over 40 years, no difference between patients with/without FAI (P = 0.119) was seen.

Conclusions: GTPS was more frequently observed in patients with normal hip morphology than in patients with FAI, particularly in patients under 40.

Keywords: Femoroacetabular impingement; Greater trochanter pain syndrome; Hip; Magnetic resonance arthrography; Trochanteric bursitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bursitis / diagnostic imaging
  • Child
  • Female
  • Femoracetabular Impingement / diagnostic imaging*
  • Femoracetabular Impingement / epidemiology
  • Femur / diagnostic imaging*
  • Humans
  • Incidence
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Pain / epidemiology*
  • Pain / etiology
  • Retrospective Studies
  • Syndrome