大转子疼痛综合征诊断及治疗的研究进展

Progress in diagnosis and treatment of greater trochanteric pain syndrome

大转子疼痛综合征(GTPS)是髋部及臀部疼痛的常见原因,多见于中年及老年女性,其病因复杂,诊断及治疗极具挑战性。GTPS包括转子滑囊炎、臀肌肌腱病、弹响髋或髋外侧滑囊炎等,X线检查可见大转子表面不规则,MRI显示大转子区域异常信号。特殊体格检查表现为单腿站立测试或特伦德伦堡征阳性。其治疗以保守治疗为主,医学运动疗法、肌肉能量技术、体外冲击波疗法、药物注射、富含血小板血浆注射等有助于缓解疼痛、改善症状。保守治疗无效时可进行手术治疗。目前手术治疗方案的选择仍存在较大争议。本文对GTPS诊断及治疗的研究进展进行综述。

Greater trochanteric pain syndrome is a common cause of hip pain and often affects middle-aged and elderly women.Its diagnosis and treatment are extremely challenging due to the complex etiology.The syndrome includes greater trochanteric bursitis,gluteal tendinopathy,snapping hip,and bursitis of the outer hips,etc.X-ray examination showed irregular surface of the greater trochanter.MRI showed abnormal signals in the greater trochanter area.Special physical examination showed a positive one-leg standing or Trendelenburg sign.The conservative treatment is mainly used.Exercise therapy,muscle energy technology,extracorporeal shock wave therapy,drug injection and platelet rich plasma(PRP)injection are helpful to relieve pain and release symptoms.Symptomatic surgical treatment can be performed when conservative treatment is ineffective.But there is still controversy over surgical treatment options.We reviewed the research progress in the diagnosis and treatment of greater trochanteric pain syndrome in this paper.