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Prognosis of trochanteric pain in primary care
Annet Lievense1, Sita Bierma-Zeinstra, Boris Schouten
1Department of General Practice, Erasmus Medical Centre, Room WK-131, PO Box 1738, 3000 DR Rotterdam, The Netherlands. a.lievense@erasmusmc.nl
Background:
Trochanteric pain is the second most important diagnosis of hip problems presenting in primary care, but its incidence and prognosis in this context is largely unknown.
Aim:
To determine the 1- and 5-year prognoses of trochanteric pain and the predictive variables for consistent complaints.
Design Of The Study:
Retrospective cohort study.
Setting:
One hundred and sixty-four patients (mean age = 55 years, 80% female) with incidental trochanteric pain in the years 1996 or 2000 were asked in 2001 for past and present symptoms of trochanteric pain. Therapeutic interventions, demographic factors and comorbidity were also investigated.
Method:
The databases of 39 GPs were screened in order to identify all incident cases with a suspicion of trochanteric pain in the years 1996 or 2000. These cases were sent a questionnaire.
Results:
The incidence of trochanteric pain in primary care is 1.8 patients per 1000 per year. After 1 year at least 36% still suffered from trochanteric pain, and after 5 years this was 29%. Patients with osteoarthritis (OA) in the lower limbs had a 4.8-fold risk of persistent symptoms after 1 year, as compared to patients without OA. Patients who had received a corticosteroid injection had a 2.7-fold chance of recovery after 5 years, as compared with patients who had not received an injection.
Conclusion:
Trochanteric pain is shown to be a chronic disease in a substantial number of patients. The disorder is associated with much impairment when conducting daily activities.