A narrative review on greater trochanteric pain syndrome: diagnostic imaging and non-surgical treatments

Background: Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, primarily affecting middle-aged women. It involves tendinopathy or tears of the gluteus medius and minimus tendons, often misdiagnosed as trochanteric bursitis. Accurate diagnosis and management require thorough clinical assessment and diagnostic imaging. Methods: This review examines the pathogenesis, clinical examination, and diagnostic tools like ultrasound (US) and magnetic resonance imaging (MRI) for GTPS. A narrative literature was conducted from May 2002 to February 2024 using PubMed. A total of 85 articles were reviewed, with 56 included, focusing on conservative and interventional treatments such as physical therapy, extracorporeal shock wave therapy (ESWT), corticosteroid injections, and platelet-rich plasma (PRP). Results: Non-surgical interventions showed variable efficacy. ESWT provided significant long-term pain relief, while corticosteroid injections offered short-term benefits that diminished over time. PRP injections demonstrated sustained improvement. US-guided procedures were found superior in precisely targeting anatomical structures. Conclusions: GTPS remains a challenging, often chronic condition. Non-surgical approaches can effectively manage early stages, but persistent cases may require advanced interventional strategies. Further research is needed to standardize treatment protocols, particularly for severe tendinopathy cases.