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Greater trochanteric pain syndrome — SCE Rheumatology MCQ

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EasyOsteoarthritis and soft tissue rheumatologyGreater trochanteric pain syndromeSCE Rheumatology

A 63-year-old man has lateral hip pain worse when lying on that side. Examination shows there is focal tenderness over the greater trochanter. Investigations show hip internal rotation is preserved. The diagnosis is established and symptoms remain clinically important despite initial supportive measures. There is no contraindication to disease-modifying or anti-inflammatory escalation. What is the most appropriate management?

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Correct answer: D — Activity modification

Activity modification is the best answer because activity modification is the most appropriate next step for greater trochanteric pain syndrome in this clinical setting. Bisphosphonate therapy is a plausible distractor, but it does not account for the key discriminator in the stem. Urgent antibiotics and Surgical opinion would be more appropriate in a different clinical pattern or at another point in the pathway, while Oral prednisolone is suboptimal for this presentation. Clinical pearl: rheumatology management is generally treat-to-target, but infection risk, pregnancy plans and shared-care monitoring often determine the safest answer.

Reference: NICE NG226; NICE CKS musculoskeletal topics