title: The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study.
abstract: OBJECTIVE
  To evaluate if pelvic or hip width predisposed women to developing greater trochanteric pain syndrome (GTPS).
  
  
  METHODS
  Prospective case control study.
  
  
  METHODS
  Four groups were included in the study: those gluteal tendon reconstructions (n=31, GTR), those with conservatively managed GTPS (n=29), those with hip osteoarthritis (n=20, OA) and 22 asymptomatic participants (ASC).
  
  
  METHODS
  Anterior-posterior pelvic x-rays were evaluated for femoral neck shaft angle; acetabular index, and width at the lateral acetabulum, and the superior and lateral aspects of the greater trochanter. Body mass index, and waist, hip and greater trochanter girth were measured. Data were analysed using a one-way analysis of variance (ANOVA; posthoc Scheffe analysis), then multivariate analysis.
  
  
  RESULTS
  The GTR group had a lower femoral neck shaft angle than the other groups (p=0.007). The OR (95% CI) of having a neck shaft angle of less than 134°, relative to the ASC group: GTR=3.33 (1.26 to 8.85); GTPS=1.4 (0.52 to 3.75); OA=0.85 (0.28 to 2.61). The OR of GTR relative to GTPS was 2.4 (1.01 to 5.6). No group difference was found for acetabular or greater trochanter width. Greater trochanter girth produced the only anthropometric group difference (mean (95% CI) in cm) GTR=103.8 (100.3 to 107.3), GTPS=105.9 (100.2 to 111.6), OA=100.3 (97.7 to 103.9), ASC=99.1 (94.7 to 103.5), (ANOVA: p=0.036). Multivariate analysis confirmed adiposity is associated with GTPS.
  
  
  CONCLUSIONS
  A lower neck shaft angle is a risk factor for, and adiposity is associated with, GTPS in women.
authors.affiliation: Department of Medicine, Biology and the Environment, Australian National University, Canberra, Australian Capital Territory, Australia. angie.fearon@hiphealth.ca
authors.forename: Am
authors.initials: A
authors.lastname: Fearon
authors.forename: S
authors.initials: S
authors.lastname: Stephens
authors.forename: Jl
authors.initials: J
authors.lastname: Cook
authors.forename: Pn
authors.initials: P
authors.lastname: Smith
authors.forename: T
authors.initials: T
authors.lastname: Neeman
authors.forename: W
authors.initials: W
authors.lastname: Cormick
authors.forename: Jm
authors.initials: J
authors.lastname: Scarvell
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000886:Anthropometry; D018771:Arthralgia / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D005272:Femur Neck / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D015207:Osteoarthritis, Hip / Q000473:pathology*; D010384:Pelvic Bones / Q000473:pathology; D010808:Physical Examination; D011446:Prospective Studies; D012307:Risk Factors; D013577:Syndrome; D052256:Tendinopathy / Q000473:pathology*; D055815:Young Adult