Williams Bryan S, Cohen Steven P
Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Rush University Medical Center, Chicago, Illinois 60612-3833, USA.
Anesth Analg. 2009 May;108(5):1662-70. doi: 10.1213/ane.0b013e31819d6562.
Greater trochanteric pain syndrome (GTPS) is a term used to describe chronic pain overlying the lateral aspect of the hip. This regional pain syndrome, once described as trochanteric bursitis, often mimics pain generated from other sources, including, but not limited to myofascial pain, degenerative joint disease, and spinal pathology. The incidence of greater trochanteric pain is reported to be approximately 1.8 patients per 1000 per year with the prevalence being higher in women, and patients with coexisting low back pain, osteoarthritis, iliotibial band tenderness, and obesity. Symptoms of GTPS consist of persistent pain in the lateral hip radiating along the lateral aspect of the thigh to the knee and occasionally below the knee and/or buttock. Physical examination reveals point tenderness in the posterolateral area of the greater trochanter. Most cases of GTPS are self-limited with conservative measures, such as physical therapy, weight loss, nonsteroidal antiinflammatory drugs and behavior modification, providing resolution of symptoms. Other treatment modalities include bursa or lateral hip injections performed with corticosteroid and local anesthetic. More invasive surgical interventions have anecdotally been reported to provide pain relief when conservative treatment modalities fail.
大转子疼痛综合征(GTPS)是一个用于描述髋关节外侧慢性疼痛的术语。这种区域性疼痛综合征,曾被称为转子滑囊炎,常与其他原因引起的疼痛相似,包括但不限于肌筋膜疼痛、退行性关节病和脊柱病变。据报道,大转子疼痛的发病率约为每年每1000人中有1.8例患者,女性、同时患有腰痛、骨关节炎、髂胫束压痛和肥胖症的患者患病率更高。GTPS的症状包括髋关节外侧持续疼痛,沿大腿外侧放射至膝盖,偶尔会放射至膝盖以下和/或臀部。体格检查发现大转子后外侧区域有压痛。大多数GTPS病例通过保守治疗措施可自愈,如物理治疗、减肥、使用非甾体抗炎药和行为改变,症状可得到缓解。其他治疗方式包括使用皮质类固醇和局部麻醉剂进行滑囊或髋关节外侧注射。据传闻,当保守治疗方法失败时,更具侵入性的手术干预可缓解疼痛。