Grimaldi Alison, Mellor Rebecca, Nasser Anthony, Vicenzino Bill, Hunter David J
School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.
PhysioTec, Tarragindi, Queensland, Australia.
Rheumatol Adv Pract. 2024 Apr 10;8(2):rkae022. doi: 10.1093/rap/rkae022. eCollection 2024.
Tendinopathy describes persistent tendon pain and loss of function related to mechanical loading. Two common hip tendinopathies seen in practice are gluteal tendinopathy and proximal hamstring tendinopathy. Both conditions can be frustrating for patients and clinicians due to the delay in diagnosis, significant disability caused and lack of response to common treatments. Tendinopathy is a clinical diagnosis and can most often be made using findings from the patient interview and pain provocation tests, without the need for imaging. Specific education and progressive exercise offer a low-risk and effective option for gluteal tendinopathy and result in greater rates of treatment success than corticosteroid injection, both in the short term (8 weeks) and at 1 year. Proximal hamstring tendinopathy is a common, but less researched, and under-recognized cause of persistent ischial pain. As research on proximal hamstring tendinopathy is limited, this review summarizes the available evidence on diagnosis and treatment following similar principles to other well-researched tendinopathies.
肌腱病是指与机械负荷相关的持续性肌腱疼痛和功能丧失。在临床实践中常见的两种髋部肌腱病是臀肌肌腱病和腘绳肌近端肌腱病。由于诊断延迟、导致的严重残疾以及对常规治疗缺乏反应，这两种病症对患者和临床医生来说都可能令人沮丧。肌腱病是一种临床诊断，通常可以根据患者访谈结果和疼痛激发试验做出诊断，无需影像学检查。对于臀肌肌腱病，特定的教育和渐进性锻炼提供了一种低风险且有效的选择，并且在短期（8周）和1年时，其治疗成功率均高于皮质类固醇注射。腘绳肌近端肌腱病是持续性坐骨疼痛的常见原因，但研究较少且未得到充分认识。由于关于腘绳肌近端肌腱病的研究有限，本综述按照与其他研究充分的肌腱病相似的原则，总结了关于诊断和治疗的现有证据。
