Calcifications Likely With Greater Trochanteric Pain Syndrome

Pertrochanteric calcifications are common among patients with greater trochanteric pain syndrome, a new study finds.

“A systematic description of the types and prevalence of these calcifications has not been undertaken. Furthermore, there is conflicting evidence regarding their association with abductor tendon injuries,” wrote the researchers of “Pertrochanteric Calcifications in Patients With Greater Trochanteric Pain Syndrome: Description, Prevalence, and Correlation With Intraoperatively Diagnosed Hip Abductor Tendon Injuries.”

The study which was published online on May 06, 2021 in The American Journal of Sports Medicine sought to describe the types and prevalence of these calcifications and determine their relationship with hip abductor tendon injuries, including tendinosis, partial-thickness tears, and full-thickness tears.

For the study, data was collected on patients who underwent surgical management for greater trochanteric pain syndrome between April 2008 and February 2020. Eighty-five of the procedures were isolated treatment of greater trochanteric pain syndrome and 628 were ancillary to hip arthroscopy.

The researchers used radiographs to identify pertrochanteric calcifications and during the surgery classified the hip abductor status.

Overall, no tear was found in 340 hips (47.7%), 289 hips (40.5%) had a partial-thickness tear, and 84 hips (11.8%) had a full-thickness tears.

On the radiographs, 102 hips showed proximally directed enthesophytes and 34 had distally directed enthesophytes. Seventy-five of the hips has amorphous calcifications, 47 had isolated ossicles and 110 had surface irregularities.

The presence of any calcification was associated with partial-thickness tears (OR, 1.67 [95% CI, 1.21-2.21]; p = .002) and full-thickness tears (OR, 6.40 [95% CI, 3.91-10.47]; p < .001).

The researchers also reported that distally directed enthesophytes (OR, 10.18 [95% CI, 3.08-33.63]; p < .001) and proximally directed enthesophytes (OR, 8.69 [ 95% CI, 4.66-16.21]; p < .001) had the highest OR for a full-thickness tear (OR, 15.79 [95% CI, 7.55-33.06]; p < .001).

Isolated ossicles had the highest OR for a partial-thickness tear (OR, 1.73 [(%% CI, 0.96-3.13]; p = .070).

The researchers wrote, “Pertrochanteric calcifications were common radiographic findings in patients with greater trochanteric pain syndrome and can help guide management in these patients. Proximally and distally directed enthesophytes were strong predictors for the presence of a hip abductor tendon tear, and specifically a full-thickness tear, and increasing size of the findings was associated with more severe tendon injuries.”