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CompletedNCT07510763Updated Apr 13, 2026

Piriformis and Gluteal Muscle Thickness in Patients With Unilateral Greater Trochanteric Pain Syndrome

An observational study in Greater Trochanteric Pain Syndrome, Deep Gluteal Syndrome and Gluteal Tendinopathy, sponsored by Ankara Etlik City Hospital. Completed at 1 site in Turkey (Türkiye). Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-04-13.

Sponsored by Ankara Etlik City Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
60
Ages
18 Years and older
Sex
All
01

Study summary

This study aims to evaluate muscle thickness in patients with unilateral Greater Trochanteric Pain Syndrome using ultrasonography and to compare these findings with healthy individuals. The primary objective is to determine whether piriformis muscle thickness differs between patients and controls. Secondary objectives include assessing gluteus medius and gluteus maximus muscle thickness, side-to-side differences in piriformis and gluteal muscle thickness, and the presence of Deep Gluteal Syndrome.

Read the detailed description

This observational cross-sectional study investigates ultrasonographic muscle morphology and associated clinical findings in patients with unilateral Greater Trochanteric Pain Syndrome (GTPS), focusing on piriformis and gluteal muscle thickness, symptom severity, and Deep Gluteal Syndrome-related findings.

Participants with unilateral GTPS and healthy controls are recruited from outpatient clinical settings. The clinical diagnosis of Greater Trochanteric Pain Syndrome is based on the presence of lateral hip pain in combination with at least two of the following findings: tenderness over the greater trochanter on palpation, pain during a 30-second single-leg stance test, or supportive ultrasonographic findings.

Ultrasonographic evaluations are performed bilaterally to measure piriformis, gluteus medius, and gluteus maximus muscle thickness. For each muscle, three measurements are obtained, and the mean value is used for analysis. Inter-side differences between affected and unaffected hips in the GTPS group and between both hips in the control group are calculated to assess asymmetry.

In the control group, the mean values of both hips are calculated and used as reference values. Comparisons are performed between affected and unaffected hips within the patient group. In addition, muscle thickness of the affected and unaffected hips in the GTPS group is compared separately with the control group mean values for each muscle. Inter-side differences in muscle thickness are also compared between patients and healthy controls. Trochanteric bursal fluid and Doppler signal changes are also evaluated using ultrasonography.

The presence of Deep Gluteal Syndrome is determined based on clinical criteria, defined as at least one clinical finding together with at least two positive standardized clinical provocation tests. Patients are categorized as Deep Gluteal Syndrome-positive or negative accordingly.

Symptom severity is assessed using the VISA-G (Victorian Institute of Sport Assessment-Gluteal) questionnaire. Correlation analyses are performed to evaluate the association between VISA-G scores and inter-side differences in muscle thickness.

02

Conditions studied

  • Greater Trochanteric Pain Syndrome
  • Deep Gluteal Syndrome
  • Gluteal Tendinopathy

Keywords

  • Greater Trochanteric Pain Syndrome
  • Musculoskeletal Ultrasound
  • Deep Gluteal Syndrome
  • Hip Pain
  • Muscle Thickness
  • Piriformis Muscle
  • Gluteal Muscle Thickness
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Adults with unilateral Greater Trochanteric Pain Syndrome and healthy individuals without hip pain or known musculoskeletal disorders are being recruited. Participants are evaluated using ultrasonography in an outpatient clinical setting.

Inclusion criteria

  • Adults aged 18 years or older
  • Diagnosis of unilateral Greater Trochanteric Pain Syndrome

Exclusion criteria

Exclusion Criteria:

  • Presence of lumbar radiculopathy
  • Presence of hip or spinal osteoarthritis
  • History of lumbar spine or lower extremity surgery
  • Presence of neurological disorders affecting muscles or peripheral nerves
  • Pregnancy
  • Presence of cognitive impairment or neuropsychiatric conditions limiting participation
  • Unwillingness to participate
  • Regular participation in physical exercise (defined as more than two sessions per week)
04

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
60 participants (actual)
Patient registry
No

Groups and cohorts

  • GTPS Patients

    Patients with unilateral Greater Trochanteric Pain Syndrome evaluated with ultrasonography

  • Healthy Controls

    Healthy individuals without hip pain or known musculoskeletal disorders, evaluated using ultrasonography

05

What researchers measure

Primary outcomes

  1. Piriformis Muscle Thickness

    Comparison of piriformis muscle thickness between patients with unilateral Greater Trochanteric Pain Syndrome and healthy controls using ultrasonography

    Time frame: At baseline

Secondary outcomes

  1. Gluteus Medius and Gluteus Maximus Muscle Thickness

    Comparison of gluteus medius and gluteus maximus muscle thickness between patients with unilateral Greater Trochanteric Pain Syndrome and healthy controls using ultrasonography.

    Time frame: At baseline

  2. Side-to-Side Muscle Thickness Comparison

    Within-group comparison of piriformis, gluteus medius, and gluteus maximus muscle thickness between affected and unaffected sides in patients with unilateral Greater Trochanteric Pain Syndrome.

    Time frame: At baseline

  3. Trochanteric Bursa and Doppler Findings

    Assessment of trochanteric bursal fluid and Doppler signal changes in patients with Greater Trochanteric Pain Syndrome using ultrasonography.

    Time frame: At baseline

  4. Prevalence of Deep Gluteal Syndrome

    Assessment of the presence of Deep Gluteal Syndrome in patients with Greater Trochanteric Pain Syndrome based on clinical evaluation and standardized provocation tests.

    Time frame: At baseline

  5. Correlation Between VISA-G Score and Hip Muscle Thickness Asymmetry

    Correlation between VISA-G score and inter-side muscle thickness differences of piriformis, gluteus medius, and gluteus maximus measured by ultrasonography in the patient group.

    Time frame: At baseline

  6. Inter-side difference in muscle thickness between patients and controls

    Comparison of inter-side differences in piriformis, gluteus medius, and gluteus maximus muscle thickness between patients with unilateral Greater Trochanteric Pain Syndrome and healthy controls using ultrasonography

    Time frame: At baseline

06

Study locations

1 site
  • Ankara Etlik City Hospital
    Ankara, 06170, Turkey (Türkiye)
07

References and documents

Publications

  • Firat A, Veizi E, Karaman Y, Alkan H, Sahin A, Tolunay T, Kilicarslan K. Unrepaired Trochanteric Bursae as a Risk Factor for Deep Gluteal Syndrome After Total Hip Arthroplasty: A Prospective Randomized Controlled Trial. J Arthroplasty. 2024 Apr;39(4):1025-1030. doi: 10.1016/j.arth.2023.10.049. Epub 2023 Nov 2. PubMed 37924993 ↗
  • Othman IK, Raj NB, Siew Kuan C, Sidek S, Wong LS, Djearamane S, Loganathan A, Selvaraj S. Association of Piriformis Thickness, Hip Muscle Strength, and Low Back Pain Patients with and without Piriformis Syndrome in Malaysia. Life (Basel). 2023 May 18;13(5):1208. doi: 10.3390/life13051208. PubMed 37240853 ↗
  • Whittaker JL, Emery CA. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014 Aug;44(8):627-32. doi: 10.2519/jospt.2014.5315. Epub 2014 Jul 16. PubMed 25029916 ↗
  • Geler Kulcu D. Deep Gluteal syndrome: An underestimated cause of posterior hip pain. Turk J Phys Med Rehabil. 2024 Feb 1;70(1):4-16. doi: 10.5606/tftrd.2024.14668. eCollection 2024 Mar. PubMed 38549816 ↗
  • Speers CJ, Bhogal GS. Greater trochanteric pain syndrome: a review of diagnosis and management in general practice. Br J Gen Pract. 2017 Oct;67(663):479-480. doi: 10.3399/bjgp17X693041. No abstract available. PubMed 28963433 ↗
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Registry details

Key details

Study ID
NCT07510763
Lead sponsor
Ankara Etlik City Hospital
Responsible party
Başak Mansız-Kaplan (Associate Professor, Ankara Etlik City Hospital) — Principal investigator
First posted
Apr 3, 2026
Start date
Dec 2, 2025
Primary completion
Mar 31, 2026
Completion
Mar 31, 2026
Last update
Apr 13, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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