Marcaccio Stephen E, Babu Jacob M, Shah Kalpit, Budacki Ross, Tabaddor Ramin R
Division of Sports Medicine, Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University.
R I Med J (2013). 2018 Dec 3;101(10):46-50.
Greater Trochanteric Pain Syndrome (GTPS) is a common cause of lateral hip pain, with an incidence of 1.8 per 1000 patients, most commonly occurring between the fourth and sixth decades of life. When GTPS fails to improve with conservative management, hip abductor insufficiency should be suspected. The diagnosis of hip abductor insufficiency is made by a combination of physical exam findings and imaging studies, with Magnetic Resonance Imaging (MRI) being the diagnostic study of choice. Initial conservative management consists of activity modification, physical therapy, non-steroidal anti-inflam- matories and corticosteroid injections. If conservative management fails, this may be suggestive of a hip abductor tear. Surgical intervention has been shown to provide excellent outcomes, and may be necessary if a tear is present. The purpose of this paper is to review and raise awareness of hip abductor insufficiency as an under- diagnosed and under-treated condition that can limit patient mobility and quality of life.
大转子疼痛综合征(GTPS)是髋关节外侧疼痛的常见原因,发病率为每1000名患者中有1.8例,最常发生在40至60岁之间。当GTPS经保守治疗无改善时,应怀疑存在髋外展肌功能不全。髋外展肌功能不全的诊断需结合体格检查结果和影像学检查,磁共振成像(MRI)是首选的诊断性检查。初始保守治疗包括调整活动、物理治疗、非甾体类抗炎药和皮质类固醇注射。如果保守治疗失败,可能提示存在髋外展肌撕裂。手术干预已被证明能取得良好效果,如果存在撕裂可能是必要的。本文的目的是回顾并提高对髋外展肌功能不全这一诊断不足和治疗不足的疾病的认识,该疾病会限制患者的活动能力和生活质量。