Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

17. The Orthopedic Perspective on Groin Pain…
235
Fig. 17.1. Intra-articular
hip pathology is excluded
by painless hip rotation
and a negative
Stinchfield test.
articular hip pathology is excluded by painless hip rotation and a negative
Stinchfield test (Fig. 17.1 ). The Stinchfield test is done with the patient in
a supine position and the examiner applying downward pressure on the
thigh as the patient actively elevates the leg as high as possible; pain during
this maneuver signifies a positive test and is indicative of likely intraarticular
pathology. An injection with steroid into the trochanteric bursa
region is both diagnostic and often therapeutic. On rare occasions, open or
endoscopic bursectomy may be considered, but results are not very predictable.
Refractory cases warrant obtaining an MRI or an ultrasound to
rule out more significant abductor tears or an intra-articular process [ 1 ].
Lastly, coxa saltans externa , a less common cause of GTPS, refers to
snapping of the iliotibial band or the anterior border of the gluteus maximus
muscle over the greater trochanter when the hip is brought from a
flexed position to an extended position. While it less commonly causes
pain, when it does, the pain may radiate from the side of the hip into the
groin. After physical therapy trials, surgical treatment consists of a variety
of iliotibial band release procedures [ 2 , 3 ].