Greater trochanteric pain syndrome — SCE Rheumatology MCQ

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EasyOsteoarthritis and Soft Tissue RheumatologyGreater trochanteric pain syndromeSCE Rheumatology

A 61-year-old woman has lateral hip pain worse lying on that side and climbing stairs. Hip internal rotation is preserved and straight-leg raise is negative. Tenderness is maximal over the greater trochanter. Pelvic radiograph shows only mild OA. What is the most likely diagnosis?

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Correct answer: A — Greater trochanteric pain syndrome

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as D · D = shown as E

Greater trochanteric pain syndrome is best because lateral hip tenderness with preserved hip rotation is typical of greater trochanteric pain syndrome. A is less suitable because lumbar radiculopathy would produce dermatomal neurological features; B is less suitable because hip OA usually causes groin pain and reduced internal rotation; C is less suitable because septic arthritis causes acute severe pain with systemic features; D is less suitable because femoral neck fracture follows trauma and impairs weight-bearing acutely. Clinical pearl: many patients who report hip pain have peri-trochanteric rather than intra-articular disease.

Reference: Oxford Textbook of Rheumatology