Differential Diagnosis for Lateral Hip Pain and Greater Trochanter Tenderness
Single Most Likely Diagnosis
- Greater Trochanteric Bursitis/Pain Syndrome (GTPS): This condition is characterized by pain and tenderness over the greater trochanter, often accompanied by a palpable soft tissue slippage or clicking sensation due to the movement of the iliotibial (IT) band over the trochanter. The symptoms described closely match the typical presentation of GTPS.
Other Likely Diagnoses
- Iliotibial (IT) Band Syndrome: This condition involves inflammation of the IT band, which runs down the outside of the thigh from the hip to the knee, and can cause lateral hip pain and a clicking sensation as it moves over the greater trochanter.
- Gluteus Medius Tendinopathy: Inflammation or degeneration of the gluteus medius tendon, which attaches to the greater trochanter, can cause pain and tenderness in the lateral hip area.
- Piriformis Syndrome: Although more commonly associated with sciatica, piriformis syndrome can also cause lateral hip pain due to the piriformis muscle's proximity to the greater trochanter and its potential to irritate nearby structures.
Do Not Miss Diagnoses
- Hip Fracture: While less likely in the absence of significant trauma, a stress fracture or an occult fracture of the hip should be considered, especially in older adults or those with risk factors for osteoporosis.
- Avulsion Fracture of the Greater Trochanter: A fracture where a piece of bone is pulled off by a tendon or ligament, which could present with similar symptoms.
- Septic Arthritis or Osteomyelitis: Infection within the hip joint or bone, which is a medical emergency requiring prompt diagnosis and treatment.
Rare Diagnoses
- Trochanteric Fracture Nonunion: A complication of a previous hip fracture where the bone fails to heal properly, potentially causing chronic pain and instability.
- Soft Tissue Tumors: Rarely, soft tissue masses (benign or malignant) around the hip can cause pain and a palpable mass.
- Bony Tumors: Similarly, bony lesions (such as osteoid osteomas or other benign/malignant tumors) in the region of the greater trochanter can cause localized pain and tenderness.