Leg-length inequality is not associated with greater trochanteric pain syndrome

Neil A Segal¹ , William Harvey² , David T Felson² , Mei Yang² , James C Torner³ , Jeffrey R Curtis⁴ and Michael C Nevitt⁵ for the Multicenter Osteoarthritis Study Group

¹Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 0728 JPP, Iowa City, IA 52242-1088, USA

²Boston University Clinical Epidemiology Research Training Unit, Boston University School of Medicine, 715 Albany Street, A203, Boston, MA 02118, USA

³Department of Epidemiology, University of Iowa School of Public Health, C-21P-1 GH, Iowa City, IA 52242, USA

⁴Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th Street South, FOT 840, Birmingham, AL 35294, USA

⁵Department of Epidemiology & Biostatistics, University of California, San Francisco, Box 0560, 185 Berry Street, Lobby 4, Suite 5700, San Francisco, CA 94107-1762, USA

author email corresponding author email

Arthritis Research & Therapy 2008, 10:R62doi:10.1186/ar2433


Published:	29 May 2008

Abstract

Introduction

Greater trochanteric pain syndrome (GTPS) is a common condition, the pathogenesis of which is incompletely understood. Although leg-length inequality has been suggested as a potential risk factor for GTPS, this widely held assumption has not been tested.

Methods

A cross-sectional analysis of greater trochanteric tenderness to palpation was performed in subjects with complaints of hip pain and no signs of hip osteoarthritis or generalized myofascial tenderness. Subjects were recruited from one clinical center of the Multicenter Osteoarthritis Study, a multicenter population-based study of community-dwelling adults aged 50 to 79 years. Diagnosis of GTPS was based on a standardized physical examination performed by trained examiners, and technicians measured leg length on full-limb anteroposterior radiographs.

Results

A total of 1,482 subjects were eligible for analysis of GTPS and leg length. Subjects' mean ± standard deviation age was 62.4 ± 8.2 years, and 59.8% were female. A total of 372 lower limbs from 271 subjects met the definition for having GTPS. Leg-length inequality (difference ≥ 1 cm) was present in 37 subjects with GTPS and in 163 subjects without GTPS (P = 0.86). Using a variety of definitions of leg-length inequality, including categorical and continuous measures, there was no association of this parameter with the occurrence of GTPS (for example, for ≥ 1 cm leg-length inequality, odds ratio = 1.17 (95% confidence interval = 0.79 to 1.73)). In adjusted analyses, female sex was significantly associated with the presence of GTPS, with an adjusted odds ratio of 3.04 (95% confidence interval = 2.07 to 4.47).

Conclusion

The present study found no evidence to support an association between leg-length inequality and greater trochanteric pain syndrome.