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Table 2

Differential Diagnosis, Clinical Features, Orthopedic Testing, and Diagnostic Imaging for an Adult Presenting With Lateral Hip Paina

DifferentialClinical Features/Orthopedic TestingDiagnostic Imagingb
Gluteal tendinopathy/proximal iliotibial band pathology/trochanteric bursitisTendinopathy most common
Pain around the greater trochanter that may radiate into the lateral thigh to the level of the knee
Pain characterized as burning or deep dull ache over the posterior hip or lateral thigh that can become sharp when moving the hip from flexion to extension
Active abduction of the hip, prolonged sitting, climbing stairs, and side-lying typically exacerbate symptoms
Trendelenburg sign, resisted hip abduction, resisted hip internal rotation and the resisted hip external derotation tests

External snapping hipObserved snapping over the greater trochanter with related painTypically diagnosed clinically

Lateral femoral cutaneous neuropathySensory for anterolateral thigh to the knee
Risk factors include: Prior hip or spine surgery, obesity, pregnancy, tight fitting clothes or other objects such as police belts, iliacus hematoma
Neurodynamic testing with side-lying hip extension and adduction

Iliohypogastric neuropathySensory along the superolateral gluteal region
Neurodynamic testing is similar to lateral femoral cutaneous nerve with addition of trunk extension and lateral bending.
CTA = computed tomographic arthrography
MRA = magnetic resonance arthrography
MRI = magnetic resonance imaging
R = radiography
SS = skeletal scintigraphy
US = ultrasonography.

aMyofascial pain syndrome should be considered in each compartment.
bDiagnostic imaging recommendations discussed in the manuscript are listed in alphabetical order and not in order of utility.