Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic left lateral hip pain, localized to the greater trochanteric region. Pain is exacerbated by weight-bearing, side-lying on the affected side, and prolonged ambulation. Patient reports a positive Trendelenburg gait and localized tenderness upon palpation of the gluteus medius insertion. No history of acute trauma; symptoms are consistent with degenerative tendinopathy or partial-thickness tear.
Clinical Examination Findings
Left hip examination reveals focal tenderness at the greater trochanter. Active abduction is limited by pain. Trendelenburg test is positive on the left. Resisted hip abduction demonstrates significant weakness (grade 3+/5) and reproduction of lateral hip pain. FABER and FADIR tests are negative for intra-articular pathology. Neurovascular status is intact distally.
Treatment Protocol
Initiate conservative management including activity modification, avoidance of side-lying on the left, and physical therapy focusing on gluteal strengthening and pelvic stabilization. Consider NSAIDs for inflammation control. If refractory, evaluate for corticosteroid or PRP injection under ultrasound guidance. Surgical consultation for repair if conservative measures fail after 3-6 months.