Ho Garry Wai Keung, Howard Thomas Michael
VCU-Fairfax Family Practice Sports Medicine Fellowship, Fairfax, VA 22033, USA.
Curr Sports Med Rep. 2012 Sep-Oct;11(5):232-8. doi: 10.1249/JSR.0b013e3182698f47.
Disorders causing lateral hip pain are encountered frequently by physicians. Evaluating these problems can be challenging because of the myriad of potential causes, the complex anatomy of the peritrochanteric structures, and the inconsistently described etiologic factors. Misconceptions about the causes of lateral hip pain and tenderness are common, frequently leading to approaches that only provide temporary solutions rather than address the underlying pathology. Trochanteric bursitis is implicated frequently but is seldom the primary cause of pain in chronic cases. It is important to address hip rotator cuff tendinopathy and pelvic core instability. Treatment options include therapeutic exercise, physical modalities, corticosteroid injections, extracorporeal shock wave therapy, and regenerative injection therapies. For recalcitrant cases, surgery may be appropriate. By understanding the anatomy of the peritrochanteric structures, and the pathologic processes most likely responsible for symptomatology and dysfunction, the physician will be prepared to provide effective long-term solutions for this common problem.
医生经常会遇到导致髋关节外侧疼痛的病症。由于潜在病因众多、转子周围结构解剖复杂以及病因描述不一致，评估这些问题具有挑战性。关于髋关节外侧疼痛和压痛原因的误解很常见，常常导致只能提供临时解决方案而非解决潜在病理问题的治疗方法。转子滑囊炎常被提及，但在慢性病例中很少是疼痛的主要原因。解决髋部旋转袖肌腱病和骨盆核心不稳定很重要。治疗选择包括治疗性锻炼、物理治疗、皮质类固醇注射、体外冲击波疗法和再生注射疗法。对于顽固性病例，手术可能是合适的。通过了解转子周围结构的解剖以及最有可能导致症状和功能障碍的病理过程，医生将有能力为这个常见问题提供有效的长期解决方案。
