Donati D, Tedeschi R, Garnum P E, Vita F, Tarallo L, Faldini C, Catani F
University of Modena and Reggio Emilia, Modena, Italy.
Policlinico di Modena, Modena, Italy.
Musculoskelet Surg. 2025 Sep 19. doi: 10.1007/s12306-025-00924-7.
Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, primarily affecting middle-aged women. It involves tendinopathy or tears of the gluteus medius and minimus tendons, often misdiagnosed as trochanteric bursitis. Accurate diagnosis and management require thorough clinical assessment and diagnostic imaging.
This review examines the pathogenesis, clinical examination, and diagnostic tools like ultrasound (US) and magnetic resonance imaging (MRI) for GTPS. A narrative literature was conducted from May 2002 to February 2024 using PubMed. A total of 85 articles were reviewed, with 56 included, focusing on conservative and interventional treatments such as physical therapy, extracorporeal shock wave therapy (ESWT), corticosteroid injections, and platelet-rich plasma (PRP).
Non-surgical interventions showed variable efficacy. ESWT provided significant long-term pain relief, while corticosteroid injections offered short-term benefits that diminished over time. PRP injections demonstrated sustained improvement. US-guided procedures were found superior in precisely targeting anatomical structures.
GTPS remains a challenging, often chronic condition. Non-surgical approaches can effectively manage early stages, but persistent cases may require advanced interventional strategies. Further research is needed to standardize treatment protocols, particularly for severe tendinopathy cases.
大转子疼痛综合征（GTPS）是髋部外侧疼痛的常见原因，主要影响中年女性。它涉及臀中肌和臀小肌腱病或肌腱撕裂，常被误诊为转子滑囊炎。准确的诊断和管理需要全面的临床评估和诊断成像。
本综述探讨了GTPS的发病机制、临床检查以及超声（US）和磁共振成像（MRI）等诊断工具。2002年5月至2024年2月在PubMed上进行了叙述性文献检索。共审查了85篇文章，纳入56篇，重点关注保守和介入治疗，如物理治疗、体外冲击波疗法（ESWT）、皮质类固醇注射和富血小板血浆（PRP）。
非手术干预显示出不同的疗效。ESWT能显著缓解长期疼痛，而皮质类固醇注射提供短期益处，但随着时间推移会减弱。PRP注射显示出持续改善。发现超声引导下的操作在精确靶向解剖结构方面更具优势。
GTPS仍然是一种具有挑战性的、通常为慢性的病症。非手术方法可有效管理早期阶段，但持续性病例可能需要先进的介入策略。需要进一步研究以规范治疗方案，特别是对于严重肌腱病病例。
