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greater trochanteric pain syndrome(GTPS) - Coggle Diagram
greater trochanteric pain syndrome(GTPS)
包括
bursitis
muscles tears:gluteus medius、minimus、TFL
coxa saltans(external hip snapping):ITB 反覆摩擦greater trochanteric
相關解剖
peritrochanteric space
subgluteus maximus bursa(trochanteric bursa):cushion for gluteus tendons、ITB、TFL，減少反覆摩擦
淺到深
淺
gluteus maximus、TFL、ITB fibromuscular sheath
中
trochanteric bursa
深:
hip stabilizer->glut med、glut mini
複習
除了gluteus maximus外(inferior gluteal nerve)，臀區皆為superior gluteal nerve所支配
insertion:
gluteus max:ITB、gluteal tuberosity
gluteus minimus:greater trochanteric
Etiology
repetitive microtrauma
mechanical overload
altered gait pattern
leg discrepancy
過高BMI
sign
tenderness over lateral side of the hip
disomfort doing hip rotation、abd、adduction、resisited hip abduction
positive Patrick's test(palpation on the greater trochanteric)->bursitis
posteriorlateral thighs region or pain form lower back into the leg
aggravating factors: side-bending、prolonged sitting、laying on the affected side
snapping sound
跛行、長短腳
trendelenberg's sign->abductor weakness
treatment
physical therpay
hip abductors、quadriceps strengthening、ITB stretching
參考資料:裡面有各種test跟differential diagnosis的圖表可看 :
https://www.ncbi.nlm.nih.gov/books/NBK557433/