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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 7/2010

01-07-2010 | Basic Research

Does Ultrasound Correlate with Surgical or Histologic Findings in Greater Trochanteric Pain Syndrome? A Pilot Study

Authors: A. M. Fearon, MPhysio, J. M. Scarvell, PhD, J. L. Cook, PhD, P. N. Smith, FRACS

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2010

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Abstract

Background

Greater trochanteric pain syndrome can be severely debilitating. Ideal imaging modalities are not established, treatments are not reliably evaluated, and the underlying pathology is not well understood.

Questions/purposes

Using surgical and histopathology findings as a gold standard, we therefore determined the positive predictive value of preoperative ultrasound assessment for greater trochanteric pain syndrome recalcitrant to nonoperative management. In addition, we report the outcomes of gluteal tendon reconstructive surgery using validated clinical and functional outcome tools and evaluate the contribution of the tendon and bursa to greater trochanteric pain syndrome.

Patients and Methods

We reviewed 24 patients who had combined gluteal tendon reconstruction and bursectomy. Preoperative ultrasound imaging was compared with surgical findings. In the absence of a greater trochanteric pain syndrome specific outcome tool, surgical outcomes for pain and function were assessed via a 100-mm visual analog scale, the modified Harris hip score, and the Oswestry Disability Index. Strength also was measured. The tendon and bursa tissue collected at surgery was histopathologically reviewed.

Results

In our small study, ultrasound had a high positive predictive value for gluteal tendon tears (positive predictive value = 1.0). Patients reported high levels of pain relief and function after surgery; tendon and bursa showed pathologic changes.

Conclusions

Ultrasound appears to be clinically useful in greater trochanteric pain syndrome; reconstructive surgery seems to relieve pain and the histopathologic findings show tendinopathy and bursa pathology coexist in greater trochanteric pain syndrome.

Level of Evidence

Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Does Ultrasound Correlate with Surgical or Histologic Findings in Greater Trochanteric Pain Syndrome? A Pilot Study
Authors
A. M. Fearon, MPhysio
J. M. Scarvell, PhD
J. L. Cook, PhD
P. N. Smith, FRACS
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 7/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1174-2

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