Table 1 Pathoanatomic approach; within the greater trochanter triangle (adult) (diagnoses appear in order of frequency in an athletic population)
Define and AlignPathologyListen and LocalisePalpate and RecreateAlleviate and Investigate
Within the triangle (adult)Femoro-acetabular impingementMechanical symptoms, clicking ± locking.Impingement test.6Plain film x-ray, magnetic resonance imaging ± arthrogram.13
Labral injury
OsteoarthritisInsidious onset, night pain.Limited ROM, especially internal rotation.14Plain film x-ray.
Femoral stress fracture
NeckGroin pain.Hop test.15Plain film x-ray, isotope bone scans, magnetic resonance imaging.
ShaftProximal thigh/knee pain.Fulcrum test.16Plain film x-ray, isotope bone scan, magnetic resonance imaging.
Inflammatory conditionsFeatures of systemic inflammation.Systemic manifestations of particular condition.17Plain film x-ray, ultrasound-guided joint aspiration.
Septic arthritisSystemic inflammatory response.Inability to weight bear, limited range of motion, ± sepsis.18Plain film x-ray, fluoroscopically/ultrasound-guided joint aspiration.
Avascular necrosis of femoral headMechanical symptoms more prominent than functional limitation.Limited range of motion.19Plain film x-ray, magnetic resonance imaging.
TumourSystemic “red flags”, absence of appropriate physical stressors.20May mimic stress fracture.20Plain film x-ray, computerised tomography (CT)/magnetic resonance imaging,21 biopsy.