Risk Factors for Trochanteric Pain Syndrome
Female sex is the most significant risk factor for greater trochanteric pain syndrome (GTPS), with women being 3.37 times more likely to develop this condition than men. 1
Primary Risk Factors
- Female sex: Women have a significantly higher prevalence (23.5% combined unilateral and bilateral) compared to men (8.5% combined) 1
- Coexisting musculoskeletal conditions:
Biomechanical Risk Factors
- Altered lower limb biomechanics from:
- Obesity: While some studies suggest a relationship, multivariate analysis shows this may be confounded by other factors 1
Age and Demographic Factors
- Age: Peak incidence between fourth and sixth decades of life, though cases occur in all age groups 3
- Race: Not significantly associated with GTPS development 1
Functional Associations
- Reduced mobility: Bilateral GTPS is associated with:
- No significant reduction in hip internal rotation despite symptoms 1
Clinical Implications
- GTPS should be considered in patients with chronic low back pain or sciatica, especially in women 4
- The American College of Radiology recommends radiographs as first-line imaging for suspected cases 5
- Ultrasound can detect associated trochanteric bursitis and tendinopathy, though differentiating between bursitis and gluteus medius tendinosis may be difficult 6, 5
- MRI is optimal for assessing peritrochanteric structures including gluteus medius/minimus muscles and tendons 6, 5
Common Pitfalls in Diagnosis
- GTPS often mimics other conditions, including:
- In patients with hip arthroplasty, extracapsular disease associated with adverse reactions to metal debris can be misinterpreted as trochanteric bursitis 6
Understanding these risk factors helps identify patients at higher risk for GTPS and guides appropriate diagnostic workup and management strategies.