Table 3 Pathoanatomic approach; superior to the greater trochanter triangle (diagnoses appear in order of frequency in an athletic population)
Define and AlignPathologyListen and LocalisePalpate and RecreateAlleviate and Investigate
Superior to the triangleMyofascial trigger points in gluteus medius and tensae fasciae lataeGluteal and lateral leg tightness and discomfort ± accompanying lateral knee pain.Restricted movement/strength in affected muscle.31 Tender “trigger” points palpable within muscle.18 19Dry needling effective in relieving trigger points.32
Greater trochanter pain syndromeWeakness in stance phase of walking and/or running, climbing stairs.33Trendelenberg test 72% sensitive, 76% specificity.34Ultrasound.35
Gluteus medius tendinopathy
Trochanteric bursitisBoggy feel and swelling.Pain on rising/standing.34Ultrasound, relief of pain by local anaesthetic injection.36
Apophysitis; iliac crestAge group (13–25 years),23 activity load.Point tenderness,24 painful Trendelenberg.4Plain film x-ray,25 computerised tomography (CT).26