Define and align | Pathology | Listen and localise | Palpate and recreate | Alleviate and investigate |
Lateral to triangle | Trochanteric bursitis | Pain getting up off bed or painful on lying on floor37 | Tenderness directly superior and over greater trochanter | Ultrasound scan +/− local anaesthetic injection38 |
Tensor fasciae latae/Iliotibial band syndrome | “Snapping” of hip, sharp burning pain lateral thigh worsens with exercise | Recreate snapping,39Ober’s test41 | Ultrasound scan34 | |
Femoral-acetabular | Mechanical symptoms, clicking +/− locking | Impingement test41 | MRI, magnetic resonance arthrogram42 | |
I. Acetabular/labral | ||||
II. Degenerative | Night pain, restriction in daily living | Limited range of movement,43 pain on weight bearing. | Plain film x ray, MRI18 | |
Stress fracture neck of femur | Female, change in volume of training Osteopenia | Hop test,44 Fulcrum test45 | Plain filmBone Scan17, MRI18 | |
Lateral cutaneous nerve entrapment | Exercise induced para/hyperaesthesia | Reproduction of symptoms on pressure inferior to ASIS46 | Relief of pain by local anaesthetic47Nerve conduction studies |
ASIS, anterior superior iliac spine; MRI, magnetic resonance imaging.