Table 3.
Common risk factors, subjective and objective findings, and general intervention for greater trochanteric pain syndrome and hip stress fracture, and the findings for the subject of this case report
| GTPS | Hip Stress Fracture | Findings in this Case Report | |
|---|---|---|---|
| Risk factors | Female gender, obesity, knee osteoarthritis or knee pain, iliotibial band tenderness, and low back pain1, 40‐60 years of age3 | Training errors (high mileage, high intensity, abrupt change in training program, footwear, training surfaces), female gender, low bone mineral density, female athlete triad (disordered eating, amenorrhea, osteoporosis)17,18 | Abruptly changed frequency, duration, and intensity of workout routine, female gender |
| Pain description | Achiness, stiffness of lateral hip1 | Ache18 | Deep ache |
| Mechanism of injury | Often insidious, chronic, intermittent3,4 | Gradual onset, abrupt change of activity12 | Gradually worsening after abrupt change in workout |
| Aggravating factors | Lying on the affected side, prolonged standing, sitting cross‐legged, climbing stairs, running, high impact activities3,4 | Repetitive training, weight bearing,26 activity‐related pain18 | High impact weight bearing activities |
| Alleviating factors | Rest | Partially relieved by rest26 | Rest |
| Objective measures | Pain and/or weakness with resisted hip abduction3 | Weakness of right hip abductors | |
| Tenderness around greater trochanter3 | Focal tenderness, swelling, and erythema18 | Significant palpable tenderness proximal and posterior to greater trochanter | |
| Pain at end‐range hip ROM3 | Normal hip ROM38; pain at extreme end‐range internal or external rotation26 | Pain‐free hip ROM | |
| Trendelenburg sign3 | Antalgic gait18 | Positive Trendelenburg sign | |
| Positive heel tap or hop test18 | Positive SL hop test on concrete surface | ||
| Negative SL hop test on foam surface | |||
| Special tests | Positive FABER3 | Positive patellar‐pubic percussion test36,37 | Negative FADIR, FABER, hip scour |
| Negative patellar‐pubic percussion test | |||
| General intervention | Conservative treatment (nonsteroidal anti‐inflammatory drugs, ice, weight loss, physical therapy, behavior modification)3 | Varies from surgical intervention to relative rest17,18 | Conservative: patient to avoid running and high level LE plyometrics. Weight bearing as tolerated for four weeks |
GTPS = greater trochanteric pain syndrome; ROM = range of motion; SL = single legged; FABER test = flexion, abduction, external rotation; FADIR test = flexion, adduction, internal rotation; LE = lower extremity.