Diagnostic accuracy of clinical tests for assessing greater trochanteric pain syndrome: a systematic review with meta-analysis

Review written by Dr Joshua Heerey info

Key Points

  1. Early diagnosis of greater trochanteric pain syndrome (GTPS) may improve outcomes in patients.
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BACKGROUND & OBJECTIVE

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, affecting up to 25% of the population (1). Several factors increase the risk of GTPS, including age, sex (female > male), low back pain and increased adiposity (2). Patients with GTPS are often unable to exercise and report altered sleep and lower quality of life. Correct diagnosis of lateral hip conditions is challenging due to the proximity of musculotendinous and bony structures. It is further complicated by the overlap in symptoms in different hip conditions and existence of multiple entities in those with longstanding pain (3).

Imaging techniques (e.g. magnetic resonance imaging (MRI) and ultrasound (US)) are used to diagnose GTPS, but are limited by cost and the high prevalence of abnormalities in asymptomatic individuals. With these limitations in mind, clinical examination is critical for diagnosis of GTPS. Several different tests have been developed for diagnosing GTPS, however, the accuracy of these tests has not been studied in detail.

Therefore, this systematic review and meta-analysis sought to determine the accuracy of clinical tests to diagnose GTPS.

Greater trochanteric pain syndrome is a common cause of lateral hip pain, affecting up to 25% of the population.
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Clinicians are encouraged to use greater trochanter palpation followed by a resisted hip abduction test if greater trochanteric pain syndrome is suspected after subjective examination.

METHODS

The authors pre-registered the systematic review protocol and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Handbook of Systematic Reviews for Diagnostic Accuracy Studies. In total, seven medical databases were searched for diagnostic accuracy

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