Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 216

ICD Coding

• ICD-9-CM Code 726.5
• ICD-10-AM code M70.6

Brief description

This SOP covers two different but related pathologies which cause lateral hip pain in adults. The structures involved are the bursa of the greater trochanter (not the lesser trochanter) and the tendon of the gluteus minimus and gluteus medius muscles (not the gluteus maximus).

The greater trochanter is the bony protuberance on the proximal part of the femur on the lateral aspect of the hip and it is at this site that the overlying bursa can become inflamed [trochanteric bursitis].  The gluteal muscles originate from the outer ilium of the pelvis and insert near the greater trochanter on the proximal femur.  It is the gluteal minimus and medius tendon which is subject to inflammation (tendinopathy) and degeneration (tendinosis). 

Confirming the diagnosis

The diagnosis is based on the clinical presentation (lateral hip pain that is worse with activity and direct pressure, tenderness over the greater trochanter).  Radiological imaging (X-ray, ultrasound, MRI) is useful to confirm the pathology and rule out other causes of lateral hip pain.

The relevant medical specialist is an orthopaedic surgeon or rheumatologist.

Additional diagnoses covered by this SOP

• Greater trochanteric pain syndrome

Conditions excluded from this SOP

• Femoroacetabular impingement^*
• Gluteus maximus tendinopathy^#
• Osteoarthritis of the hip*
• Piriformis syndrome^#
• Snapping hip syndrome^#

* another SOP applies  - the SOP has the same name unless otherwise specified

^# non-SOP condition

Clinical onset

Once the diagnosis is confirmed clinical onset can be backdated to when the current relevant symptoms first manifest.   

Clinical worsening

The natural history of the condition is to improve or resolve within one to two years in most subjects.  The condition is generally responsive to conservative treatment, with surgery being required in some cases.