Pathogenesis and contemporary diagnoses for lateral hip pain: a scoping review

Key points

1. 01Lateral hip pain can be grouped into greater trochanteric pain syndrome (GTPS), gluteal abductor tendon tears, and external snapping hip
2. 02The anterolateral tendon of the gluteus medius is especially prone to tearing
3. 03Increased acetabular anteversion is associated with gluteal tendon problems and bursitis
4. 04Useful clinical tests include the single-leg stance, resisted external derotation, hip lag sign, and Trendelenburg test
5. 05Dynamic ultrasound, guided injection, and MRI help tell the different causes apart

How it was conducted

Design

Scoping review of the literature via PubMed

Topics covered

GTPS, trochanteric bursitis, gluteus medius tears, external snapping hip

Articles included

49 articles

Focus

Pathoanatomy, clinical assessment, and diagnosis of peritrochanteric space pathology

Level of evidence

IV

What they found

• Lateral hip pain was classified into three categories: GTPS, abductor tendon tears, and external snapping hip
• The gluteus medius anterolateral tendon was identified as prone to tears
• Increased acetabular anteversion was associated with gluteal tendon problems and bursitis
• Single-leg stance, resisted external derotation, hip lag sign, and Trendelenburg test were noted as useful diagnostic tests
• Dynamic ultrasound, guided injection, and MRI were reported to help differentiate the underlying pathology
• Assessing psychological impairment was highlighted as relevant to outcomes

Limitations

• This is a scoping review (Level of evidence IV), which maps existing literature rather than testing interventions in a controlled way
• Only the descriptive findings are reported, with no pooled effect sizes, sensitivities, or specificities provided
• Drawing on 49 selected articles from a single database (PubMed) limits how comprehensive the evidence base is
• As a narrative synthesis, conclusions reflect expert interpretation and are subject to selection and reporting bias

Why it matters

For patients

If you have pain on the outer hip, it may stem from several related causes, so a careful exam plus an ultrasound or MRI can help find the specific problem.

For clinicians

Use a combination of physical tests (single-leg stance, resisted external derotation, hip lag sign, Trendelenburg) and imaging to distinguish GTPS, abductor tears, and external snapping hip, and consider psychological factors that affect outcomes.

For readers

Lateral hip pain is an umbrella term covering distinct conditions, and accurate diagnosis depends on matching clinical signs to the right imaging.