Revisión de conceptos actuales: síndrome doloroso del espacio peritrocantérico

Autores/as

  • William Henry Márquez Arabia Clínica las Américas. Medellín, Colombia
  • Juan Gómez-Hoyos Universidad de Antioquia. Medellín, Colombia
  • Juan Fernando Llano Clínica las Américas. Medellín, Colombia

DOI:

https://doi.org/10.1016/S0120-8845(13)70004-X

Palabras clave:

articulación de la cadera, cadera/anatomía, síndrome, dolor/diagnóstico, bursitis, traumatismos de los tendones, nivel de evidencia: IV

Resumen

El dolor lateral de la cadera frecuentemente se convierte en un reto diagnóstico y en un problema terapéutico debido a la amplitud de diagnósticos diferenciales que deben ser tenidos en cuenta, esto implica que hay un grupo de signos y síntomas relacionados con el dolor peritrocantérico, y puede ser más complejo que una inflamación simple de las bursas peritrocantéricas. El 2,5 % de las lesiones deportivas comprometen la cadera y la incidencia de dolor en el trocánter mayor se ha estimado en 1.8 pacientes por 1000 por cada año. Esta patología se presenta en el adulto, con mayor prevalencia entre la cuarta y la sexta década de la vida. Las alteraciones específicas del espacio peritrocantérico son la bursitis trocantérica, la cadera en resorte externo (coxa saltans externa) y las rupturas de los tendones del glúteo medio y menor. Se presenta una revisión de la literatura científica que permita al lector realizar un adecuado diagnóstico diferencial entre las patologías del espacio peritrocantérico mencionadas.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

William Henry Márquez Arabia, Clínica las Américas. Medellín, Colombia

Médico ortopedista y traumatólogo, Universidad de Antioquia, Profesor del Programa de Medicina Deportiva y miembro del Grupo de Investigación GRINMADE de la Universidad de Antioquia, Servicio de Ortopedia, Clínica las Américas, Medellín, Colombia.

Juan Gómez-Hoyos, Universidad de Antioquia. Medellín, Colombia

Médico residente de 3.er año, Posgrado de Ortopedia y Traumatología, Universidad de Antioquia, Miembro del Grupo de Investigación GRINMADE, Universidad de Antioquia, Medellín, Colombia.

Juan Fernando Llano, Clínica las Américas. Medellín, Colombia

Médico radiólogo, Instituto de Alta Tecnología Médica de Antioquia, Servicio de Radiología, Clínica las Américas, Medellín, Colombia.

Referencias bibliográficas

Segal NA, Felson DT, Torner JC, Zhu Y, Curtis JR, Niu J, et al. Greater trochanteric pain syndrome: epidemiology and associated factors. Arch Phys Med Rehabil. 2007;88:988-92. https://doi.org/10.1016/j.apmr.2007.04.014

Lievense A, Bierma-Zeinstra S, Schouten B, Bohnen A, Verhaar J, Koes B. Prognosis of trochanteric pain in primary care. Br J Gen Pract. 2005;55:199-204.

Williams B, Cohen S. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009;108:1662-70. https://doi.org/10.1213/ane.0b013e31819d6562

Strauss E, Nho S, Kelly B. Greater trochanteric pain syndrome. Sports Med Arthrosc Rev. 2010;18:113-9. https://doi.org/10.1097/JSA.0b013e3181e0b2ff

Alvarez-Nemegyei J, Canoso JJ. Evidence-based soft tissue rheumatology: III: trochanteric bursitis. J Clin Rheumatol. 2004;10:123-4. https://doi.org/10.1097/01.rhu.0000129089.57719.16

Farr D, Selesnick H, Janecki C, Cordas D. Arthroscopic bursectomy with concomitant iliotibial band release for the treatment of recalcitrant trochanteric bursitis. Arthroscopy. 2007;23:905.e1-e5. https://doi.org/10.1016/j.arthro.2006.10.021

Gottschalk F, Kourosh S, Leveau B. The functional anatomy of tensor fasciae latae and gluteus medius and minimus. J Anat. 1989;166:179-89.

Robertson W, Gardner M, Barker J, Boraiah, S, Lorich D, Kelly B. Anatomy and dimensions of the gluteus medius tendon insertion. J Arthroscopy. 2008;24:130-6. https://doi.org/10.1016/j.arthro.2007.11.015

Beck M, Sledge J, Gautier E, Dora C, Ganz R. The anatomy and function of the gluteus minimus muscle. J Bone Joint Surg. 2000;82(B):358-63. https://doi.org/10.1302/0301-620X.82B3.0820358

Walters J, Solomons M, Davies J. Gluteus minimus: observations on its insertion. J Anat. 2001;198:239-42. https://doi.org/10.1046/j.1469-7580.2001.19820239.x

Woodley S, Mercer S, Nicholson H. Morphology of the bursae associated with the greater trochanter of the femur. J Bone Joint Surg 2008;90(A):284-94. https://doi.org/10.2106/JBJS.G.00257

Dunn T, Heller CA, McCarthy SW, Dos Remedios C. Anatomical study of the "trochanteric bursa". Clin Anat. 2003;16:233-40. https://doi.org/10.1002/ca.10084

Gardner M, Robertson W, BoraiahS, Barker J, Lorich D. Anatomy of the greater trochanteric "bald spot". A potencial portal for abductor sparing femoral nailing? Clin Orthop Relat Res. 2008;466:2196-200. https://doi.org/10.1007/s11999-008-0217-4

Pfirrmann C, Chung C, Theumann N, Trudell D, Resnick D. Greater trochanter of the hip: Attachment of the abductor mechanism and a complex of three bursae-MR imaging and MR bursography in cadavers and MR imaging in asymptomatic volunteers. Radiology. 2001;221:469-77. https://doi.org/10.1148/radiol.2211001634

Ilizaliturri V, Camacho-Galindo J, Evia A, Gonzalez Y, Millan S, Busconi B. Soft tissue pathology around the hip. Clinics Sports Med. 2011;30:391-415. https://doi.org/10.1016/j.csm.2010.12.009

Anderson K, Strickland SM, Warren R. Hip and groin injuries in athletes. Am J Sports Med. 2001;29:521-33. https://doi.org/10.1177/03635465010290042501

Shbeeb MI, Matteson EL. Trochanteric bursitis (greater trochanter pain syndrome). Mayo Clin Proc. 1996;71:565-9. https://doi.org/10.4065/71.6.565

Tortolani PJ, Carbone JJ, Quartararo LG. Greater trochanteric pain syndrome in patients referred to orthopedic spine specialists. Spine J. 2002;2:251-4. https://doi.org/10.1016/S1529-9430(02)00198-5

Collee G, Dijkmans BA, Vandenbroucke JP, Rozing PM, Cats A. A clinical epidemiological study in low back pain. Description of two clinical syndromes. Br J Rheumatol. 1990;29:354-7. https://doi.org/10.1093/rheumatology/29.5.354

Schapira D, Nahir M, Scharf Y. Trochanteric bursitis: A common clinical problem. Arch Phys Med Rehabil. 1986;67:815-7.

Clancy WG. Runner's injuries. Part two. Evaluation and treatment of specific injuries. Am J Sports Med. 1980;8:287-9. https://doi.org/10.1177/036354658000800415

Baker C, Massie V, Hurt G, Savory C. Arthroscopic bursectomy for recalcitrant trochanteric bursitis. Arthroscopy. 2007;23:827-32. https://doi.org/10.1016/j.arthro.2007.02.015

Tibor LM, Sekiya JK. Differential diagnosis of pain around the hip joint. Arthroscopy. 2008;24:1407-21. https://doi.org/10.1016/j.arthro.2008.06.019

Bird PA, Oakley SP, Shnier R, Kirkham BW. Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with greater trochanteric pain syndrome. Arthritis Rheum. 2001;44:2138-45. https://doi.org/fwp2z4

Butcher JD, Salzman KL, Lillegard WA. Lower extremity bursitis. Am Fam Physician. 1996;53:2317-24.

Voss J, Rudzki J, Shindle M, Martin H, Kelly B. Arthroscopic anatomy and surgical techniques for peritrochanterics space disorders in the hip. Arthroscopy. 2007;23:1246.e1-5. https://doi.org/10.1016/j.arthro.2006.12.014

Fox JL. The role of arthroscopic bursectomy in the treatment of trochanteric bursitis. Arthroscopy. 2002;18:E34. https://doi.org/10.1053/jars.2002.35143

White RA, Hughes MS, Burd T, Hamann J, Allen WC. A new operative approach in the correction of external coxa saltans: the snapping hip. Am J Sports Med. 2004;32:1504-8. https://doi.org/10.1177/0363546503262189

Allen WC, Cope R. Coxa saltans: the snapping hip revisited. J Am Acad Orthop Surg. 1995;3:303-8. https://doi.org/10.5435/00124635-199509000-00006

Provencher MT, Hofmeister EP, Muldoon MP. The surgical treatment of external coxa saltans (the snapping hip) by Z-plasty of the iliotibial band. Am J Sports Med. 2004;32:470-6. https://doi.org/10.1177/0363546503261713

Ilizaliturri V, Camacho-Galindo J. Endoscopic treatment of snapping hips, iliotibial band, and iliopsoas tendon. Sports Med Arthrosc Rev. 2010;18:120-7. https://doi.org/10.1097/JSA.0b013e3181dc57a5

Pierannunzii L, Tramonttana F, Gallazi M. Case report. Calcific tendinitis of the rectus femoris. A rare cause of snapping hip. Clin Orthop Relat Res. 2010;468:2814-8. https://doi.org/10.1007/s11999-009-1208-9

Ilizaliturri VM Jr, Martinez-Escalante FA, Chaidez PA, Camacho-Galindo J. Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy. 2006;22:505-10. https://doi.org/10.1016/j.arthro.2005.12.030

Battaglia M, Guaraldoi F, Monti C, Vanel D, Vannini F. An unusual cause of external snapping hip. J Radiol Case Rep. 2011;5:1-6. https://doi.org/10.3941/jrcr.v5i10.821

Baker Ch III, Baker Ch Jr. Arthroscopic liotibial band lengthening and bursectomy for recalcitrant trochanteric bursitis and coxa saltans externa. En: Sekiya JK, Safran MR, Leunig M, Ranawat AS, editores. Techniques in hip arthroscopy and joint preservation surgery. Philadelphia: Saunders; 2011. https://doi.org/10.1016/B978-1-4160-5642-3.00016-5

Tibor LM, Sekiya JK. Differential diagnosis of pain around the hip joint. Arthroscopy. 2008;24:1407-21. https://doi.org/10.1016/j.arthro.2008.06.019

Pelsser V, Cardinal E, Hobden R, Aubin B, Lafortune M. Extraarticular snapping hip: sonographic findings. AJR Am J Roentgenol. 2001;176:67-73. https://doi.org/10.2214/ajr.176.1.1760067

Choi YS, Lee SM, Song BY, Paik SH, Yoon YK. Dynamic sonography of external snapping hip syndrome. J Ultrasound Med. 2002;21:753-8. https://doi.org/10.7863/jum.2002.21.7.753

Domb B, Nasser R, Botser I. Partial-thickness tears of the gluteus medius: Rationale and technique for trans-tendinous endoscopic repair. Arthroscopy. 2010;26:1697-705. https://doi.org/10.1016/j.arthro.2010.06.002

Silva F, Adams T, Feinstein J, Arroyo R. Trochanteric bursitis: Refuting the myth of inà ammation. J Clin Rheumatol. 2008;14: 82-6. https://doi.org/10.1097/RHU.0b013e31816b4471

Bird P, Oakley S, Shnier R, Kirkham W. Prospective evaluation of magnetic resonance imaging and physical examination findings in patients with Greater trochanteric pain syndrome. Arthritis Rheum. 2001;44:2138-45. https://doi.org/fwp2z4

Kingzett-Taylor A, Tirman P, Feller J, McGann W, Prieto V, Wischer T, et al. Tendinous and tears of gluteus medius and minimus muscles as a cause of hip pain: MRI imaging findings. AJR Am J Roentgenol. 1999;173:1123-6. https://doi.org/10.2214/ajr.173.4.10511191

Bunker T, Esler C, Leach W. Rotator-cuff tear of the hip. J Bone Joint Surg. 1997;79B:618-20. https://doi.org/10.1302/0301-620X.79B4.0790618

Kagan A. Rotator cuff tears of the hip. Clin Orthop. 1999;368: 135-40. https://doi.org/10.1097/00003086-199911000-00016

Howell G, Biggs R, Bourne R. Prevalence of abductor mechanism tears of the hips in patients with osteoarthritis. J Arthroplasty. 2001;16:121-3.

Cormier G, Berthelot J, Maugars I. Gluteus tendon rupture is underrecognized by French orthopedic surgeons: results of a mail survey. Joint Bone Spine. 2006;73:411-3. https://doi.org/10.1016/j.jbspin.2006.01.021

Connell DA, Bass C, Sykes CA, Young D, Edwards E. Sonographic evaluation of gluteus medius and minimus tendinopathy. Eur Radiol. 2003;13:1339-47. https://doi.org/10.1007/s00330-002-1740-4

Voss J, Maak T, Kelly B. Arthroscopic hip "rotator cuff repair" of gluteus medius tendon avulsions. En: Sekiya JK, Safran MR, Leunig M, Ranawat AS, editores. Techniques in hip arthroscopy and joint preservation surgery. Philadelphia: Saunders; 2011. https://doi.org/10.1016/B978-1-4160-5642-3.00017-7

Steinert L, Zanetti M, Hodler J, Pfirrmann C, Dora C, Naupe N. Are radiographic trochanteric surface irregularities associated with abductor tendon abnormalities? Radiology. 2010;257:754-63. https://doi.org/10.1148/radiol.10092183

Kong A, Van der Vliet A, Zadow S. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. Eur Radiol. 2007;17:1772-83. https://doi.org/10.1007/s00330-006-0485-x

Dwek J, Pfirrmann C, Stanley A, Pathria M, Chung C. MR imaging of the hip abductors: Normal anatomy and commonly encountered pathology at the greater trochanter. Magn Reson Imaging Clin N Am. 2005;13:691-704. https://doi.org/10.1016/j.mric.2005.08.004

Cvitanic O, Henzie G, Skezas N, Lyons J, Minter J. MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus). AJR Am J Roentgenol. 2004;182:137-43. https://doi.org/10.2214/ajr.182.1.1820137

Blankenbaker D, Ullrick S, Davis K, De Smet A, Haaland B, Fine J. Correlation of MRI findings with clinical findings of trochanteric pain syndrome. Skeletal Radiol. 2008;37:903-9. https://doi.org/10.1007/s00256-008-0514-8

Chung C, Robertson J, Cho G, Vaughan L, Copp S, Resnick D. Gluteus medius tendon tears and avulsive injuries in elderly women: imaging findings in six patients. AJR Am J Roentgenol. 1999;173:351-3. https://doi.org/10.2214/ajr.173.2.10430134

El-Husseiny M, Patel S, Rayan F, Haddad F. Gluteus medius tears: an under-diagnosed pathology. Br J Hospital Med. 2011;72:12-6. https://doi.org/10.12968/hmed.2011.72.1.12

Maffulli N, Longo U, Denaro V. Novel approaches for the management of tendinopathy. J Bone Joint Surg. 2010;92A:2604-13.

Bewyer D, Chen J. Gluteus medius tendon rupture as a source for back, buttock and leg pain: case report. Iowa Orthop J. 2005;25:187-9.

Ozcakar L, Erol O, Kaymak B, Aydemir N. An underdiagnosed hip pathology: apropos of two cases with gluteus medius tendon tears. Clin Rheumatol. 2004;23:464-6. https://doi.org/10.1007/s10067-004-0917-4

Lequesne M, Djian P, Vuillemin V, Mathieu P. Prospective study of refractory greater trochanter pain syndrome. MRI findings of gluteal tendon tears seen at surgery. Clinical and MRI results of tendon repair. Joint Bone Spine. 2008;75:458-64. https://doi.org/10.1016/j.jbspin.2007.12.004

Davies H, Zhaeentan S, Tavakkolizadeh A, Janes G. Surgical repair of chronic tears of the hip abductor mechanism. Hip Int. 2009;19:372-6. https://doi.org/10.1177/112070000901900412

Dishkin-Paset J, Salata M, Gross C, Manno K, Shewman E, Wang V, et al. A biomechanical comparison of repair techniques for complete gluteus medius tears. Arthroscopy. 2012;28:1410-6. https://doi.org/10.1016/j.arthro.2012.03.002

Descargas

Publicado

2013-06-25

Cómo citar

1.
Márquez Arabia WH, Gómez-Hoyos J, Llano JF. Revisión de conceptos actuales: síndrome doloroso del espacio peritrocantérico. Rev. colomb. ortop traumatol. [Internet]. 25 de junio de 2013 [citado 23 de abril de 2024];27(2):97-117. Disponible en: https://revistasccot.org/index.php/rccot/article/view/488

Número

Sección

Artículo original
QR Code
Crossref Cited-by logo

Algunos artículos similares: