Differential Diagnosis for Greater Trochanter Pain Syndrome versus Hip Arthritis

Single Most Likely Diagnosis

• Greater Trochanteric Pain Syndrome (GTPS): This condition is characterized by pain over the greater trochanter, which is the bony prominence on the outside of the hip. It is often associated with tendinopathy or bursitis of the gluteus medius or minimus tendons. The pain can mimic hip arthritis but is typically more localized to the lateral aspect of the hip.

Other Likely Diagnoses

• Hip Osteoarthritis: A common condition causing hip pain, stiffness, and limited mobility. While the pain is typically more centralized in the groin, it can sometimes radiate to the lateral hip, mimicking GTPS.
• Gluteus Medius Tendinopathy: Similar to GTPS, this condition involves inflammation or degeneration of the gluteus medius tendon, leading to pain and weakness on the lateral aspect of the hip.
• Trochanteric Bursitis: Inflammation of the bursa over the greater trochanter, which can cause pain and swelling in the area, similar to GTPS.

Do Not Miss Diagnoses

• Avascular Necrosis of the Femoral Head: A condition where the blood supply to the femoral head is interrupted, leading to necrosis of the bone tissue. It can present with hip pain and must be identified early to prevent collapse of the femoral head.
• Infection (Septic Arthritis or Osteomyelitis): Infections within the hip joint or bone can cause severe pain, redness, and swelling. Early diagnosis and treatment are crucial to prevent long-term damage.
• Stress Fracture: A fracture caused by repeated stress on a bone, which can occur in the femur or pelvis and cause hip pain. It's essential to diagnose and treat stress fractures to prevent complete fracture and potential complications.

Rare Diagnoses

• Piriformis Syndrome: A condition where the piriformis muscle irritates the sciatic nerve, causing pain, numbness, and tingling in the buttock and leg. While it can cause hip pain, it's less common than other diagnoses.
• Synovial Chondromatosis: A rare condition where cartilage grows within the synovial membrane of the joint, leading to joint pain and swelling. It's an uncommon cause of hip pain but should be considered in the differential diagnosis of hip arthritis or GTPS.