Greater trochanteric pain syndrome — SCE Rheumatology MCQ

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ModerateOsteoarthritis and Soft Tissue RheumatologyGreater trochanteric pain syndromeSCE Rheumatology

A 31-year-old woman has lateral hip pain worse lying on the affected side, focal greater trochanter tenderness and full painless internal hip rotation. What is the most appropriate investigation?

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Correct answer: C — Imaging as a sole step if atypical or refractory

Imaging only if atypical or refractory is the single best answer because lateral tenderness with preserved hip rotation suggests greater trochanteric pain syndrome. The stem is testing investigation selection, not isolated recall, so the relevant clinical pattern and risk context determine the answer. Synovial fluid microscopy, Gram stain and culture is less suitable because it fits a different clinical pattern or a different treatment threshold; MRI of the sacroiliac joints, High-resolution CT chest and Renal biopsy do not address the key discriminator in this vignette. Clinical pearl: in SCE-style rheumatology questions, autoantibodies, imaging and synovial fluid findings should be interpreted with the whole phenotype.

Reference: NICE NG226; NICE CKS soft tissue rheumatology