Fulya BAKILAN, Gökhan YÜCE, Ahmet BİCEN ÇAĞDAŞ, Kadir Serkan YALÇIN, Gökçe TANYERİ

Assessment of ultrasound imaging and physical examination fndings in greater trochanteric pain syndrome

Amaç: Bu çalışmanın amacı, büyük trokanter bölgesinde ağrısı olan hastalardaki trokanterik bursit ve gluteus medius tendinopati prevelansını ultrasonografi kullanarak belirlemek ve gluteus medius tendinopatisi tanısının konulmasında, dirençli kalça abduksiyonu ve iç rotasyonunda ağrı varlığının değerlendirilmesinin önemini belirlemektir. Yöntemler: Bu çalışma büyük trokanterde ağrısı olan 75 hasta üzerinde retrospektif analiz ile gerçekleştirilmiştir. Hastaların fizik muayene kayıtlarında dirençli kalça abduksiyon ve iç rotasyonda ağrı varlığı araştırılmıştır. Fizik muayene kayıtlarının analizinden sonra hastaların kas iskelet sistemi ultrasonografi görüntüleme kayıtları incelenmiş olup, trokanterik bursit ve gluteus medius tendinopati varlığı değerlendirilmiştir. Bulgular: Büyük trokanterde ağrısı olan 75 hastanın; %41,4ünde trokanterik bursit, %20sinde gluteus medius tendinopatisi saptanmıştır. Dirençli kalça abduksiyonu ve iç rotasyonunda ağrı varlığı, gluteus mediusta tendinopati saptanan ve saptanmayan hastalarda gluteus mediusta tendinopati lehine, istatistiksel olarak belirgin farklı bulunmuştur. Sonuç: Hastalarda büyük trokanter ağrısının etyolojisinin aydınlatabilmesinde fizik muayene ve ultrasonografi ile görüntüleme önemlidir, özellikle dirençli kalça abduksiyonu ve iç rotasyonunda ağrı varlığının değerlendirilmesi, gluteus mediusta tendinopati varlığının saptanmasında gereklidir.

Büyük trokanterik ağrı sendromunda ultrasonografi ve fizik muayene bulgularının değerlendirilmesi

Objective: The aim of this study was to investigate the prevalence of greater trochanteric bursitis and gluteus medius tendinopathy using ultrasound in patients with greater trochanteric pain and assess the value of the pain on resisted hip abduction and pain on resisted hip internal rotation in predicting the presence of gluteus medius tendinopathy. Methods: The study was a retrospective analysis of 75 patients with greater trochanteric pain. The physical examination records were identifed as pain on resisted hip abduction and hip internal rotation. After observing physical examination records, presence of greater trochanteric bursitis or gluteus medius tendinopathy were assessed in documented ultrasound fndings. Results: Of the 75 patients with greater trochanteric pain, trochanteric bursitis was found in 41.4% of patients, gluteus medius tendinopathy was found in 20% of patients. A signifcant difference was found in both presence of pain on resisted hip abduction and internal rotation between patients with gluteus medius tendinopathy and patients with other abnormalities in favor of gluteus medius tendinopathy. Conclusion: In order to determine the etiology of greater trochanteric pain, physical examination and ultrasound imaging is important, especially examination of pain on resisted hip abduction and hip internal rotation is essential to detect gluteus medius tendinopathy.

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