{"id":1468,"date":"2022-07-12T21:23:24","date_gmt":"2022-07-12T21:23:24","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/snapping-hip-and-trochanteric-bursitis-it\/"},"modified":"2026-02-04T18:55:15","modified_gmt":"2026-02-04T18:55:15","slug":"snapping-hip-and-trochanteric-bursitis-it","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/it\/snapping-hip-and-trochanteric-bursitis-it\/","title":{"rendered":"Anca a scatto e borsite trocanterica"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>Redazione originale<\/b> &#8211; <a title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\">Ewa Jaraczewska<\/a> sulla base del corso di <a class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/instructor\/rina-pandya\/\" rel=\"nofollow\">Rina Pandya<\/a><br \/>\n<b>Contributori principali<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Ewa Jaraczewska\" href=\"\/User:Ewa_Jaraczewska\"><bdi>Ewa Jaraczewska<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a> and <a class=\"mw-userlink\" title=\"User:Tarina van der Stockt\" href=\"\/User:Tarina_van_der_Stockt\"><bdi>Tarina van der Stockt<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenuti<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Snapping_Hip_Syndrome_.28SHS.29\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Sindrome dell&#8217;anca a scatto<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-2\"><a href=\"#External_Snapping_Hip_Syndrome_.28ESHS.29\"><span class=\"tocnumber\">1.1<\/span> <span class=\"toctext\">Sindrome dell&#8217;anca a scatto esterna<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-3\"><a href=\"#Internal_Snapping_Hip_Syndrome_.28ISHS.29\"><span class=\"tocnumber\">1.2<\/span> <span class=\"toctext\">Sindrome dell&#8217;anca a scatto interna<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-4\"><a href=\"#Intra-Articular_Snapping_Hip\"><span class=\"tocnumber\">1.3<\/span> <span class=\"toctext\">Anca a scatto intra-articolare<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-5\"><a href=\"#Clinically_Relevant_Anatomy\"><span class=\"tocnumber\">1.3.1<\/span> <span class=\"toctext\">Anatomia clinicamente rilevante<\/span><\/a>\n<ul>\n<li class=\"toclevel-4 tocsection-6\"><a href=\"#Iliotibial_Band\"><span class=\"tocnumber\">1.3.1.1<\/span> <span class=\"toctext\">Bandelletta ileotibiale<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-7\"><a href=\"#Gluteus_Maximus\"><span class=\"tocnumber\">1.3.1.2<\/span> <span class=\"toctext\">Grande gluteo<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-8\"><a href=\"#Iliopsoas\"><span class=\"tocnumber\">1.3.1.3<\/span> <span class=\"toctext\">Ileopsoas<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Pathophysiology\"><span class=\"tocnumber\">1.4<\/span> <span class=\"toctext\">Fisiopatologia<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Clinical_Presentation\"><span class=\"tocnumber\">1.5<\/span> <span class=\"toctext\">Presentazione clinica<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Evaluation\"><span class=\"tocnumber\">1.6<\/span> <span class=\"toctext\">Valutazione<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-12\"><a href=\"#Physiotherapy_Assessment\"><span class=\"tocnumber\">1.6.1<\/span> <span class=\"toctext\">Valutazione fisioterapica<\/span><\/a>\n<ul>\n<li class=\"toclevel-4 tocsection-13\"><a href=\"#Patient.27s_History\"><span class=\"tocnumber\">1.6.1.1<\/span> <span class=\"toctext\">Anamnesi del paziente<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-14\"><a href=\"#Physical_Examination\"><span class=\"tocnumber\">1.6.1.2<\/span> <span class=\"toctext\">Esame obiettivo<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-15\"><a href=\"#Special_Tests\"><span class=\"tocnumber\">1.6.1.3<\/span> <span class=\"toctext\">Test speciali<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-3 tocsection-16\"><a href=\"#Imaging\"><span class=\"tocnumber\">1.6.2<\/span> <span class=\"toctext\">Immagini diagnostiche<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-17\"><a href=\"#Management_.2F_Interventions\"><span class=\"tocnumber\">1.7<\/span> <span class=\"toctext\">Gestione\/Interventi<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-18\"><a href=\"#Conservative_Management\"><span class=\"tocnumber\">1.7.1<\/span> <span class=\"toctext\">Gestione conservativa<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-19\"><a href=\"#Surgical_Intervention\"><span class=\"tocnumber\">1.7.2<\/span> <span class=\"toctext\">Intervento chirurgico<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-20\"><a href=\"#Trochanteric_Bursitis\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Borsite trocanterica<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-21\"><a href=\"#Clinically_Relevant_Anatomy_2\"><span class=\"tocnumber\">2.1<\/span> <span class=\"toctext\">Anatomia clinicamente rilevante<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-22\"><a href=\"#Pathophysiology_2\"><span class=\"tocnumber\">2.2<\/span> <span class=\"toctext\">Fisiopatologia<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-23\"><a href=\"#Clinical_Presentation_2\"><span class=\"tocnumber\">2.3<\/span> <span class=\"toctext\">Presentazione clinica<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-24\"><a href=\"#Evaluation_2\"><span class=\"tocnumber\">2.4<\/span> <span class=\"toctext\">Valutazione<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-25\"><a href=\"#Physiotherapy_Assessment_2\"><span class=\"tocnumber\">2.4.1<\/span> <span class=\"toctext\">Valutazione fisioterapica<\/span><\/a>\n<ul>\n<li class=\"toclevel-4 tocsection-26\"><a href=\"#Patient.27s_History_2\"><span class=\"tocnumber\">2.4.1.1<\/span> <span class=\"toctext\">Anamnesi del paziente<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-27\"><a href=\"#Physical_Examination_2\"><span class=\"tocnumber\">2.4.1.2<\/span> <span class=\"toctext\">Esame obiettivo<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-28\"><a href=\"#Special_Tests_2\"><span class=\"tocnumber\">2.4.1.3<\/span> <span class=\"toctext\">Test speciali<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-3 tocsection-29\"><a href=\"#Imaging_2\"><span class=\"tocnumber\">2.4.2<\/span> <span class=\"toctext\">Immagini diagnostiche<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-2 tocsection-30\"><a href=\"#Management.2FInterventions\"><span class=\"tocnumber\">2.5<\/span> <span class=\"toctext\">Gestione\/Interventi<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-31\"><a href=\"#Conservative_Management_2\"><span class=\"tocnumber\">2.5.1<\/span> <span class=\"toctext\">Gestione conservativa<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-32\"><a href=\"#Surgical_Intervention_2\"><span class=\"tocnumber\">2.5.2<\/span> <span class=\"toctext\">Intervento chirurgico<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-33\"><a href=\"#Resources\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Risorse<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-34\"><a href=\"#References\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Citazioni<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Snapping_Hip_Syndrome_(SHS)\"><\/span><span id=\"Snapping_Hip_Syndrome_.28SHS.29\" class=\"mw-headline\">Sindrome dell&#8217;anca a scatto<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Snapping Hip Syndrome (SHS)\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=1\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Snapping Hip Syndrome (SHS)\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=1\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Sono stati identificati tre tipi di sindrome dell&#8217;anca a scatto: anca a scatto esterna, interna ed intra-articolare.<\/p>\n<h3><span id=\"External_Snapping_Hip_Syndrome_(ESHS)\"><\/span><span id=\"External_Snapping_Hip_Syndrome_.28ESHS.29\" class=\"mw-headline\">Sindrome dell&#8217;anca a scatto esterna<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: External Snapping Hip Syndrome (ESHS)\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=2\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: External Snapping Hip Syndrome (ESHS)\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=2\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>L&#8217;anca a scatto esterna (laterale) \u00e8 una condizione dolorosa nota anche come coxa saltans laterale. Si verifica in circa il 10% della popolazione generale.<sup id=\"cite_ref-:2_1-0\" class=\"reference\"><a href=\"#cite_note-:2-1\">(1)<\/a><\/sup> <i>Lo scatto extra-articolare esterno<\/i> \u00e8 causato dalla bandeletta ileotibiale posteriore o dalla parte anteriore del grande gluteo quando si muovono sul grande trocantere durante la flessione\/estensione dell&#8217;anca o la rotazione interna\/esterna dell&#8217;anca.<sup id=\"cite_ref-:0_2-0\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup> Questo potrebbe portare all&#8217;infiammazione della borsa trocanterica.<sup id=\"cite_ref-:0_2-1\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup> I soggetti affetti dalla sindrome dell&#8217;anca a scatto esterna potrebbero anche presentare coxa vara, tessuto cicatriziale fibrotico, un grande trocantere prominente, una minore larghezza laterale del bacino o aver subito in passato un intervento chirurgico per l&#8217;instabilit\u00e0 anterolaterale del ginocchio.<sup id=\"cite_ref-:1_3-0\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup><\/p>\n<h3><span id=\"Internal_Snapping_Hip_Syndrome_(ISHS)\"><\/span><span id=\"Internal_Snapping_Hip_Syndrome_.28ISHS.29\" class=\"mw-headline\">Sindrome dell&#8217;anca a scatto interna<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Internal Snapping Hip Syndrome (ISHS)\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=3\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Internal Snapping Hip Syndrome (ISHS)\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=3\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Lo schiocco <i>interno<\/i> <i>extra-articolare<\/i> \u00e8 causato dallo schiocco del tendine dell&#8217;ileopsoas sull&#8217;eminenza ileopettinea o sulla testa del femore ed \u00e8 pi\u00f9 probabile che si verifichi durante la contrazione dei flessori dell&#8217;anca. Altri meccanismi <i>extra-articolari<\/i> proposti per questa condizione includono:<sup id=\"cite_ref-:0_2-2\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/p>\n<ul>\n<li>Scivolamento del tendine accessorio dell&#8217;ileopsoas<\/li>\n<li>Scatto dell&#8217;ileopsoas su una cresta in corrispondenza del piccolo trocantere<\/li>\n<li>Scatto del legamento ileofemorale sulla testa del femore<\/li>\n<li>Sublussazione del capo lungo del bicipite all&#8217;altezza dell&#8217;ischio<\/li>\n<li>Scatto in corrispondenza della spina iliaca antero-inferiore.<sup id=\"cite_ref-:0_2-3\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Intra-Articular_Snapping_Hip\" class=\"mw-headline\">Anca a scatto intra-articolare<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Intra-Articular Snapping Hip\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=4\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Intra-Articular Snapping Hip\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=4\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Anche i fattori <i>intra-articolari<\/i> possono portare allo sviluppo dei sintomi dell&#8217;anca a scatto, come le lacerazioni del labbro, le lacerazioni del legamento teres, i corpi liberi come i frammenti osteocondrali o l&#8217;instabilit\u00e0 articolare.<\/p>\n<h4><span id=\"Clinically_Relevant_Anatomy\" class=\"mw-headline\">Anatomia clinicamente rilevante<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=5\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=5\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Iliotibial-band-itb-anatomy-diagrams.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/ce\/Iliotibial-band-itb-anatomy-diagrams.jpeg\/300px-Iliotibial-band-itb-anatomy-diagrams.jpeg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/ce\/Iliotibial-band-itb-anatomy-diagrams.jpeg\/450px-Iliotibial-band-itb-anatomy-diagrams.jpeg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/c\/ce\/Iliotibial-band-itb-anatomy-diagrams.jpeg\/600px-Iliotibial-band-itb-anatomy-diagrams.jpeg 2x\" alt=\"Iliotibial-band-itb-anatomy-diagrams.jpeg\" width=\"300\" height=\"300\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<h5><span id=\"Iliotibial_Band\" class=\"mw-headline\">Bandelletta ileotibiale<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Iliotibial Band\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=6\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Iliotibial Band\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=6\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<p>La <a title=\"Iliotibial Band Syndrome\" href=\"\/Iliotibial_Band_Syndrome\">bandelletta ileotibiale<\/a> (ITB) \u00e8 una spessa fascia che corre sul lato laterale della coscia a partire dalla cresta iliaca e si inserisce sul ginocchio.<sup id=\"cite_ref-5\" class=\"reference\"><a href=\"#cite_note-5\">(5)<\/a><\/sup> \u00c8 composta da un denso tessuto connettivo fibroso che ha origine dalle fibre anteriori del tensore della fascia lata e dalle fibre posteriori del grande gluteo. Dopo aver percorso la parte laterale della coscia, la maggior parte delle fibre si inserisce sul tubercolo tibiale, mentre alcune si inseriscono sul tendine del grande gluteo, sull&#8217;epicondilo femorale laterale e sul bordo laterale distale della rotula.<sup id=\"cite_ref-:2_1-1\" class=\"reference\"><a href=\"#cite_note-:2-1\">(1)<\/a><\/sup> Durante la flessione dell&#8217;anca, l&#8217;ITB si muove anteriormente al grande trocantere e durante l&#8217;estensione dell&#8217;anca scorre posteriormente ad esso.<sup id=\"cite_ref-:0_2-4\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/p>\n<p>Sull&#8217;aspetto laterale dell&#8217;articolazione dell&#8217;anca sono presenti tre borse sottoglutee: borsa del grande trocantere, borsa del medio sottogluteo e borsa del piccolo sottogluteo. La borsa trocanterica \u00e8 la pi\u00f9 grande delle tre e copre l&#8217;inserzione del tendine del medio gluteo e l&#8217;aspetto posteriore del grande trocantere. Il suo ruolo principale \u00e8 quello di ridurre l&#8217;attrito tra i tendini del medio gluteo e dell&#8217;ITB quando passano sopra al grande trocantere.<sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6)<\/a><\/sup><\/p>\n<p>La bandelletta ileotibiale \u00e8 coinvolta nella stabilizzazione dell&#8217;anca durante l&#8217;appoggio monopodalico e la deambulazione, quando agisce come tendine del <a title=\"Tensor Fascia Lata\" href=\"\/Tensor_Fascia_Lata\">tensore della fascia lata<\/a> (TFL) e del <a title=\"Gluteus Maximus\" href=\"\/Gluteus_Maximus\">grande gluteus<\/a>. La contrazione dei muscoli grande gluteo e TFL provoca un irrigidimento della banda.<\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 202px;\"><a class=\"image\" href=\"\/File:Gluteus_Medius.PNG\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0c\/Gluteus_Medius.PNG\/200px-Gluteus_Medius.PNG\" srcset=\"https:\/\/www.physio-pedia.com\/images\/0\/0c\/Gluteus_Medius.PNG 1.5x\" alt=\"\" width=\"200\" height=\"286\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<h5><span id=\"Gluteus_Maximus\" class=\"mw-headline\">Grande gluteo<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Gluteus Maximus\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=7\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Gluteus Maximus\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=7\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<p>Il <a title=\"Gluteus Maximus\" href=\"\/Gluteus_Maximus\">grande gluteo<\/a> origina dal versante esterno del segmento dorsale della cresta iliaca, dalla superficie glutea dell&#8217;ileo, dalla superficie dorsale della parte inferiore del sacro, dal lato del coccige e dal legamento sacrotuberoso. Inoltre, condivide l&#8217;attacco alla fascia toracolombare con il <a title=\"Multifidus Muscle\" href=\"\/Multifidus_Muscle\">multifido<\/a> omolaterale e il <a title=\"Latissimus Dorsi Muscle\" href=\"\/Latissimus_Dorsi_Muscle\">grande dorsale<\/a> controlaterale. Il muscolo si inserisce sulla tuberosit\u00e0 glutea e sulla bandelletta ileotibiale.<\/p>\n<p>Il grande gluteo \u00e8 coinvolto principalmente nell&#8217;estensione, nella rotazione esterna e nell&#8217;abduzione dell&#8217;anca. La sua funzione \u00e8 essenziale per mantenere una postura eretta.<\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 202px;\"><a class=\"image\" href=\"\/File:Iliopsoas_Anatomy.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/4\/42\/Iliopsoas_Anatomy.png\/200px-Iliopsoas_Anatomy.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/4\/42\/Iliopsoas_Anatomy.png 1.5x\" alt=\"\" width=\"200\" height=\"403\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<h5><span id=\"Iliopsoas\" class=\"mw-headline\">Ileopsoas<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Iliopsoas\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=8\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Iliopsoas\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=8\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<p>Il complesso muscolare dell&#8217;<a title=\"Ileopsoas\" href=\"\/Iliopsoas\">ileopsoas<\/a> \u00e8 composto da tre muscoli: <a title=\"Iliacus\" href=\"\/Iliacus\">iliaco<\/a>, <a title=\"Psoas Major\" href=\"\/Psoas_Major\">grande psoas<\/a> e <a title=\"Psoas Minor\" href=\"\/Psoas_Minor\">piccolo psoas<\/a>.<sup id=\"cite_ref-:0_2-5\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup> Pu\u00f2 funzionare come un&#8217;unit\u00e0, ma i tre muscoli hanno funzioni separate. L&#8217;iliopsoas origina dalla fusione dei muscoli grande psoas e iliaco. Questa fusione avviene a livello di L5-S2 e i muscoli combinati passano dalla pelvi alla coscia sotto al legamento inguinale. Il muscolo ileopsoas si inserisce sul piccolo trocantere del femore attraverso il tendine dello psoas.<\/p>\n<p>La borsa dell&#8217;ileopsoas \u00e8 la borsa pi\u00f9 grande dell&#8217;articolazione dell&#8217;anca e si trova in profondit\u00e0 rispetto alla giunzione muscolo-tendinea dell&#8217;ileopsoas e anteriormente alla capsula articolare dell&#8217;anca. Si ritiene che la borsa comunichi con l&#8217;articolazione dell&#8217;anca in circa il 15% dei pazienti. Aiuta il muscolo a scorrere e scivolare sulla parte anteriore dell&#8217;anca durante il movimento.<sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7)<\/a><\/sup><\/p>\n<p>Il muscolo ileopsoas \u00e8 il pi\u00f9 forte flessore dell&#8217;anca e contribuisce alla rotazione esterna del femore. \u00c8 essenziale per una corretta postura lombare in stazione eretta e seduta e durante la camminata e la corsa.<\/p>\n<h3><span id=\"Pathophysiology\" class=\"mw-headline\">Fisiopatologia<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Pathophysiology\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=9\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Pathophysiology\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=9\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Anca a scatto esterna\n<ul>\n<li>Componente visiva dello scatto osservato dal paziente quando l&#8217;ITB scorre dall&#8217;aspetto <i>anteriore a quello posteriore<\/i> del grande trocantere durante il movimento dell&#8217;anca dall&#8217;<i>estensione alla flessione.<\/i> Questo \u00e8 solitamente causato dall&#8217;ispessimento della parte posteriore dell&#8217;ITB e\/o della parte anteriore del grande gluteo.<sup id=\"cite_ref-:3_8-0\" class=\"reference\"><a href=\"#cite_note-:3-8\">(8)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Anca a scatto interna\n<ul>\n<li>Componente udibile dello schiocco quando il movimento del tendine dell&#8217;ileopsoas dalla posizione <i>laterale a quella mediale<\/i> \u00e8 limitato durante <i>l&#8217;estensione e la rotazione interna<\/i> dell&#8217;anca. Questa limitazione pu\u00f2 essere causata dalla testa del femore o dall&#8217;eminenza pettineale della pelvi.<sup id=\"cite_ref-:3_8-1\" class=\"reference\"><a href=\"#cite_note-:3-8\">(8)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Anca a scatto intra-articolare\n<ul>\n<li>Processo patologico dell&#8217;articolazione dell&#8217;anca in cui corpi liberi, lacerazioni del labbro acetabolare o fratture osteocondrali possono interferire con l&#8217;articolazione della testa del femore nell&#8217;acetabolo.<sup id=\"cite_ref-:3_8-2\" class=\"reference\"><a href=\"#cite_note-:3-8\">(8)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><span id=\"Clinical_Presentation\" class=\"mw-headline\">Presentazione clinica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=10\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=10\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>I soggetti affetti dalla sindrome dell&#8217;<i>anca a scatto esterno<\/i> solitamente descrivono una sensazione come se l&#8217;anca si stesse lussando. Con l&#8217;<i>anca a scatto interna<\/i>, i pazienti descrivono una sensazione all&#8217;articolazione dell&#8217;anca come se fosse &#8220;incastrata&#8221; o bloccata e riferiscono di sentire il suono dello scatto. Il suono intermittente di un clic o di un blocco caratterizza la patologia <i>intra-articolare<\/i>.<\/p>\n<p>Inoltre i pazienti possono riferire:<\/p>\n<ul>\n<li>Dolore<\/li>\n<li>Debolezza muscolare<\/li>\n<li>Limitazioni dell&#8217;attivit\u00e0<sup id=\"cite_ref-:1_3-1\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Evaluation\" class=\"mw-headline\">Valutazione<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Evaluation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=11\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Evaluation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=11\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<h4><span id=\"Physiotherapy_Assessment\" class=\"mw-headline\">Valutazione fisioterapica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Physiotherapy Assessment\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=12\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Physiotherapy Assessment\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=12\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>La valutazione fisioterapica comprende l&#8217;anamnesi del paziente, l&#8217;esame obiettivo e i test speciali.<\/p>\n<h5><span id=\"Patient's_History\"><\/span><span id=\"Patient.27s_History\" class=\"mw-headline\">Anamnesi del paziente<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Patient's History\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=13\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Patient's History\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=13\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li>Descrizione dei sintomi (localizzazione, sensazione, tempi e durata)<\/li>\n<li>Impatto sulle attivit\u00e0 della vita quotidiana<\/li>\n<\/ul>\n<h5><span id=\"Physical_Examination\" class=\"mw-headline\">Esame obiettivo<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Physical Examination\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=14\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Physical Examination\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=14\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li>Palpazione articolare: lo schiocco palpato a livello dell&#8217;anca anteriore indica una coxa saltans interna<\/li>\n<li>Valutazione dell&#8217;escursione di movimento<\/li>\n<li>Valutazione della forza<\/li>\n<li>Valutazione del dolore (<a title=\"Visual Analogue Scale\" href=\"\/Visual_Analogue_Scale\">scala analogica visiva<\/a>)<\/li>\n<li>Valutazione funzionale, compresa la <a title=\"Passo\" href=\"\/Gait\">valutazione della deambulazione<\/a>.<\/li>\n<\/ul>\n<h5><span id=\"Special_Tests\" class=\"mw-headline\">Test speciali<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Special Tests\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=15\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Special Tests\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=15\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<p><b>Sindrome dell&#8217;anca a scatto esterna:<\/b><\/p>\n<ul>\n<li>Test di FADIR incluse la flessione, l&#8217;adduzione e larotazione interna o il conflitto<\/li>\n<li><a title=\"Ober's Test\" href=\"\/Ober%27s_Test\">Test di Ober<\/a>: valutazione della rigidit\u00e0 dell&#8217;ITB<sup id=\"cite_ref-:10_9-0\" class=\"reference\"><a href=\"#cite_note-:10-9\">(9)<\/a><\/sup><\/li>\n<li>Flessione attiva dell&#8217;anca seguita da estensione ed abduzione passive: un test positivo riproduce lo scatto sul grande trocantere.<\/li>\n<li>Il test dell&#8217;Hula Hoop \u00e8 un test alternativo che prevede l&#8217;adduzione e la circonduzione dell&#8217;anca in stazione eretta. Test positivo: viene riprodotto lo schiocco sul grande trocantere<\/li>\n<li>Anomalie biomeccaniche (<a title=\"Trendelenburg Sign\" href=\"\/Trendelenburg_Sign\">segno di Trendelenburg<\/a>)<\/li>\n<\/ul>\n<p><b>Sindrome dell&#8217;anca a scatto interna:<\/b><\/p>\n<ul>\n<li>Test dinamico (giro della morte): si parte dalla posizione <a title=\"FABER Test\" href=\"\/FABER_Test\">FABER<\/a> (flessione, abduzione e rotazione esterna) e si passa alla posizione EADIR (estensione, adduzione e rotazione interna). Test positivo: scatto del tendine dell&#8217;iliopsoas<sup id=\"cite_ref-:11_10-0\" class=\"reference\"><a href=\"#cite_note-:11-10\">(10)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li><a title=\"Thomas Test\" href=\"\/Thomas_Test\">Test di Thomas<\/a>: un test positivo indica una contrattura dello psoas<sup id=\"cite_ref-:12_11-0\" class=\"reference\"><a href=\"#cite_note-:12-11\">(11)<\/a><\/sup><\/li>\n<li><a class=\"external text\" href=\"https:\/\/www.physio-pedia.com\/Snapping_Hip_Syndrome?utm_source=physiopedia&amp;utm_medium=search&amp;utm_campaign=ongoing_internal#Examination\" rel=\"nofollow\">Test di Stinchfield<\/a>: Il paziente \u00e8 sdraiato in posizione supina con l&#8217;anca flessa a 30\u00b0. Al paziente viene chiesto di flettere completamente l&#8217;anca, mentre l&#8217;esaminatore applica una forza di resistenza. Il dolore nella parte anteriore dell&#8217;inguine indica un test positivo.<\/li>\n<\/ul>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/xkEq7nGUA1o?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-:11_10-1\" class=\"reference\"><a href=\"#cite_note-:11-10\">(10)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/6FEvmhjMVNs?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-:10_9-1\" class=\"reference\"><a href=\"#cite_note-:10-9\">(9)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/qsgrMVuataI?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-:12_11-1\" class=\"reference\"><a href=\"#cite_note-:12-11\">(11)<\/a><\/sup><\/p>\n<h4><span id=\"Imaging\" class=\"mw-headline\">Immagini diagnostiche<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Imaging\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=16\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Imaging\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=16\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Radiografia: nessun reperto tipico indicativo di coxa saltans interna. Il conflitto femoro-acetabolare pu\u00f2 essere rilevato da una radiografia semplice.<sup id=\"cite_ref-:0_2-6\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<li>Risonanza magnetica: non specifica per il coinvolgimento dell&#8217;ileopsoas. Pu\u00f2 aiutare nella diagnosi di infiammazione della borsa dell&#8217;ileopsoas o del muscolo ileopsoas. Questa modalit\u00e0 aiuta a visualizzare un&#8217;ITB ispessita e un ispessimento focale del grande gluteo quando si sospetta una sindrome dell&#8217;anca a scatto esterna.<sup id=\"cite_ref-:0_2-7\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<li>Ecografia: aiuta a visualizzare il movimento dinamico del tendine dell&#8217;ileopsoas, ma richiede un professionista clinico esperto per l&#8217;esecuzione e l&#8217;interpretazione dei risultati.<sup id=\"cite_ref-:0_2-8\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-12\" class=\"reference\"><a href=\"#cite_note-12\">(12)<\/a><\/sup><\/li>\n<li>Ecografia dinamica: in grado di rilevare il movimento dell&#8217;ITB sul grande trocantere.<\/li>\n<li>Bursografia dell&#8217;ileopsoas: sotto fluoroscopia, la borsa viene riempita con liquido di contrasto per visualizzare il tendine che si muove avanti e indietro. Questa diagnostica per immagini viene eseguita per confermare la sindrome dell&#8217;anca a scatto interna.<sup id=\"cite_ref-:0_2-9\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Management_\/_Interventions\"><\/span><span id=\"Management_.2F_Interventions\" class=\"mw-headline\">Gestione\/interventi<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Management \/ Interventions\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=17\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Management \/ Interventions\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=17\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 452px;\"><a class=\"image\" href=\"\/File:ITB_stretch.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/b8\/ITB_stretch.jpg\/450px-ITB_stretch.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/b8\/ITB_stretch.jpg\/675px-ITB_stretch.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/b\/b8\/ITB_stretch.jpg\/900px-ITB_stretch.jpg 2x\" alt=\"\" width=\"450\" height=\"146\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Allungamento della bandelletta ileotibiale<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Conservative_Management\" class=\"mw-headline\">Gestione conservativa<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Conservative Management\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=18\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Conservative Management\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=18\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p><i>Obiettivo<\/i>: migliorare il dolore, aumentare la flessibilit\u00e0 e compensare la discrepanza nella lunghezza degli arti, se necessario.<\/p>\n<p>Un approccio conservativo dovrebbe essere mantenuto per almeno 6 mesi e si consigliano le seguenti strategie:<sup id=\"cite_ref-:2_1-2\" class=\"reference\"><a href=\"#cite_note-:2-1\">(1)<\/a><\/sup><\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 297px;\"><a class=\"image\" href=\"\/File:Iliopsoas_stretch.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/3\/3d\/Iliopsoas_stretch.jpg\" alt=\"\" width=\"295\" height=\"217\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Allungamento dell&#8217;ileopsoas<\/p>\n<\/div>\n<\/div>\n<\/div>\n<ol>\n<li>Per ridurre l&#8217;infiammazione si consiglia il riposo, il ghiaccio e gli antinfiammatori<sup id=\"cite_ref-:0_2-10\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<li>Deve essere identificato l&#8217;irrigidimento muscolare che causa lo scatto: deve essere avviato un programma di stretching passivo e attivo specifico per l&#8217;ITB e i muscoli iliopsoas<sup id=\"cite_ref-:0_2-11\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><\/li>\n<li>Esercizi in appoggio su una gamba sola (ESHS)<sup id=\"cite_ref-:18_13-0\" class=\"reference\"><a href=\"#cite_note-:18-13\">(13)<\/a><\/sup><\/li>\n<li>Camminata laterale con theraband (ESHS)<sup id=\"cite_ref-:18_13-1\" class=\"reference\"><a href=\"#cite_note-:18-13\">(13)<\/a><\/sup><\/li>\n<li>Esercizi per l&#8217;escursione dell&#8217;anca (ESHS)<sup id=\"cite_ref-:18_13-2\" class=\"reference\"><a href=\"#cite_note-:18-13\">(13)<\/a><\/sup><\/li>\n<li>I movimenti che provocano lo scatto dovrebbero essere evitati<\/li>\n<li>Le attivit\u00e0 sportive devono essere ridotte<\/li>\n<li>Tecniche di rilascio attivo<sup id=\"cite_ref-:18_13-3\" class=\"reference\"><a href=\"#cite_note-:18-13\">(13)<\/a><\/sup><\/li>\n<li>Uso di modalit\u00e0: terapia laser o <a title=\"Extracorporeal Shockwave Therapy (ESWT)\" href=\"\/Extracorporeal_Shockwave_Therapy_(ESWT)\">terapia con onde d&#8217;urto extracorporee ESWT<\/a><sup id=\"cite_ref-14\" class=\"reference\"><a href=\"#cite_note-14\">(14)<\/a><\/sup><\/li>\n<\/ol>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 152px;\"><a class=\"image\" href=\"\/File:ITB_release_technique.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/9e\/ITB_release_technique.png\/150px-ITB_release_technique.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/9e\/ITB_release_technique.png\/225px-ITB_release_technique.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/9e\/ITB_release_technique.png\/299px-ITB_release_technique.png 2x\" alt=\"\" width=\"150\" height=\"297\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p><small><i>Tecnica di rilascio dell&#8217;ITB di Ilizaliturri. Adattata da: Randelli F, Mazzoleni MG, Fioruzzi A, Giai Via A, Calvisi V, Ayeni OR. Interventi chirurgici per la sindrome dell&#8217;anca a scatto esterna.<\/i><\/small><\/p>\n<\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Surgical_Intervention\" class=\"mw-headline\">Intervento chirurgico<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Surgical Intervention\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=19\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Surgical Intervention\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=19\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p><i>Obiettivo<\/i>: rilasciare l&#8217;ITB contratto o l&#8217;ileopsoas per risolvere lo scatto<sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup><\/p>\n<p><b>Anca a scatto esterna:<\/b><\/p>\n<ol>\n<li>Allungamento frazionato del tendine<\/li>\n<li>Rilascio completo della porzione tendinea<sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup><\/li>\n<\/ol>\n<p>Le procedure di allungamento comprendono: rilascio a Z, allungamento formale a Z, rilascio a croce e rilascio dell&#8217;inserzione del tendine del grande gluteo sul femore.<sup id=\"cite_ref-:0_2-12\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-:2_1-3\" class=\"reference\"><a href=\"#cite_note-:2-1\">(1)<\/a><\/sup><\/p>\n<p><b>Anca a scatto interna:<\/b><\/p>\n<ol>\n<li>Approccio anteriore per il rilascio della porzione tendinea postero-mediale dell&#8217;ileopsoas<\/li>\n<li>Rilascio endoscopico del tendine dell&#8217;ileopsoas<sup id=\"cite_ref-:0_2-13\" class=\"reference\"><a href=\"#cite_note-:0-2\">(2)<\/a><\/sup><sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup><\/li>\n<\/ol>\n<h2><span id=\"Trochanteric_Bursitis\" class=\"mw-headline\">Borsite trocanterica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Trochanteric Bursitis\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=20\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Trochanteric Bursitis\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=20\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Il dolore all&#8217;anca laterale dovuto all&#8217;infiammazione della borsa, solitamente come conseguenza di microtraumi, produce una condizione chiamata borsite trocanterica o sindrome dolorosa del grande trocantere (GTPS).<sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><sup id=\"cite_ref-:4_19-0\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup> Colpisce soprattutto le donne di et\u00e0 compresa tra i 40 e i 60 anni.<sup id=\"cite_ref-:5_20-0\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup> La biomeccanica anomala dell&#8217;anca \u00e8 la causa principale dello sviluppo dei sintomi: la tendinopatia del medio e piccolo gluteo, insieme o meno alla borsite, pu\u00f2 portare a questa dolorosa sindrome laterale dell&#8217;anca.<sup id=\"cite_ref-:5_20-1\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Trochanteric_Bursitis.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0c\/Trochanteric_Bursitis.jpg\/300px-Trochanteric_Bursitis.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0c\/Trochanteric_Bursitis.jpg\/450px-Trochanteric_Bursitis.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0c\/Trochanteric_Bursitis.jpg\/600px-Trochanteric_Bursitis.jpg 2x\" alt=\"\" width=\"300\" height=\"325\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Borsite trocanterica<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Clinically_Relevant_Anatomy_2\" class=\"mw-headline\">Anatomia clinicamente rilevante<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=21\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Clinically Relevant Anatomy\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=21\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Una borsa o bursa (forma plurale) \u00e8 una sacca rivestita da una membrana sinoviale o da una sinovia contenente il liquido sinoviale.<sup id=\"cite_ref-:6_21-0\" class=\"reference\"><a href=\"#cite_note-:6-21\">(21)<\/a><\/sup> Si trova tra l&#8217;osso e i tessuti molli circostanti e vicino a un&#8217;articolazione.<sup id=\"cite_ref-:6_21-1\" class=\"reference\"><a href=\"#cite_note-:6-21\">(21)<\/a><\/sup> Il suo ruolo \u00e8 quello di lubrificare e ridurre la tensione e l&#8217;attrito tra l&#8217;interfaccia tessuto molle\/osso. Funge anche da ammortizzatore durante il movimento di muscoli e articolazioni. Informazioni dettagliate sul meccanismo di lesione o sul processo patologico della borsite sono disponibili <a title=\"Bursitis\" href=\"\/Bursitis\">qui<\/a>.<\/p>\n<p>Nel caso della <a title=\"Trochanteric Bursitis\" href=\"\/Trochanteric_Bursitis\">borsite trocanterica<\/a>, sono comunemente coinvolte due borse:<\/p>\n<ol>\n<li>Borsa del sottogluteo medio &#8211; si trova sopra il grande trocantere e sotto all&#8217;inserzione del medio gluteo.<\/li>\n<li>Bursa del sottogluteo massimo &#8211; si trova tra il grande trocantere e l&#8217;inserzione dei muscoli medio e grande gluteo.<\/li>\n<\/ol>\n<h4><span id=\"Pathophysiology_2\" class=\"mw-headline\">Fisiopatologia<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Pathophysiology\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=22\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Pathophysiology\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=22\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>L&#8217;alterazione della biomeccanica dell&#8217;arto inferiore e gli squilibri portano allo sviluppo della GTPS. L&#8217;eziologia di questa sindrome \u00e8 multifattoriale<sup id=\"cite_ref-:4_19-1\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup> e si ritiene che i seguenti problemi contribuiscano alla sua presenza:<\/p>\n<ul>\n<li>Un angolo collo-diafisi del femore pi\u00f9 basso<sup id=\"cite_ref-:7_22-0\" class=\"reference\"><a href=\"#cite_note-:7-22\">(22)<\/a><\/sup><sup id=\"cite_ref-23\" class=\"reference\"><a href=\"#cite_note-23\">(23)<\/a><\/sup><\/li>\n<li>Livelli di attivit\u00e0 aumentati di recente<sup id=\"cite_ref-:7_22-1\" class=\"reference\"><a href=\"#cite_note-:7-22\">(22)<\/a><\/sup><sup id=\"cite_ref-:8_24-0\" class=\"reference\"><a href=\"#cite_note-:8-24\">(24)<\/a><\/sup><\/li>\n<li>Calzature inadeguate<sup id=\"cite_ref-:7_22-2\" class=\"reference\"><a href=\"#cite_note-:7-22\">(22)<\/a><\/sup><\/li>\n<li>Cambiamenti ormonali dopo la menopausa<sup id=\"cite_ref-:7_22-3\" class=\"reference\"><a href=\"#cite_note-:7-22\">(22)<\/a><\/sup><sup id=\"cite_ref-25\" class=\"reference\"><a href=\"#cite_note-25\">(25)<\/a><\/sup><\/li>\n<li>Degenerazione o tendinopatia del medio e piccolo gluteo<sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/li>\n<li>Microtrauma ripetitivo della borsa causato dall&#8217;attrito tra il grande trocantere e la bandelletta ileotibiale<sup id=\"cite_ref-27\" class=\"reference\"><a href=\"#cite_note-27\">(27)<\/a><\/sup><\/li>\n<\/ul>\n<h4><span id=\"Clinical_Presentation_2\" class=\"mw-headline\">Presentazione clinica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=23\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Clinical Presentation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=23\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>La presentazione clinica pu\u00f2 essere la seguente:<\/p>\n<ul>\n<li>Dolore al lato laterale dell&#8217;anca che si irradia verso il basso<sup id=\"cite_ref-:5_20-2\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Difficolt\u00e0 a sdraiarsi sul lato interessato<sup id=\"cite_ref-:5_20-3\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Dolore mentre si cammina<sup id=\"cite_ref-:5_20-4\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Anomalie del passo<sup id=\"cite_ref-:5_20-5\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Indolenzimento in corrispondenza del grande trocantere<sup id=\"cite_ref-:8_24-1\" class=\"reference\"><a href=\"#cite_note-:8-24\">(24)<\/a><\/sup><\/li>\n<li>Dolore che interferisce con il sonno e le funzioni fisiche<sup id=\"cite_ref-:8_24-2\" class=\"reference\"><a href=\"#cite_note-:8-24\">(24)<\/a><\/sup><\/li>\n<\/ul>\n<p>Diagnosi differenziale:<\/p>\n<ul>\n<li><a title=\"Iliotibial Band Syndrome\" href=\"\/Iliotibial_Band_Syndrome\">Sindrome della bandelletta ileotibiale<\/a><\/li>\n<li><a title=\"Snapping Hip Syndrome\" href=\"\/Snapping_Hip_Syndrome\">Sindrome dell&#8217;anca a scatto<\/a><\/li>\n<li>Disfunzione e lacerazioni del tendine del medio gluteo<\/li>\n<li><a title=\"Meralgia parestesica\" href=\"\/Meralgia_Paraesthetica\">Meralgia parestesica<\/a><\/li>\n<li>Dolore riferito<\/li>\n<li><a title=\"Osteoartrosi\" href=\"\/Osteoarthritis\">Osteoartrosi<\/a><\/li>\n<li><a title=\"Low Back Pain\" href=\"\/Low_Back_Pain\">Dolore lombare<\/a><\/li>\n<li><a title=\"Pelvic Floor and Other Pelvic Disorders\" href=\"\/Pelvic_Floor_and_Other_Pelvic_Disorders\">Patologia pelvica<\/a><\/li>\n<\/ul>\n<h3><span id=\"Evaluation_2\" class=\"mw-headline\">Valutazione<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Evaluation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=24\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Evaluation\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=24\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<h4><span id=\"Physiotherapy_Assessment_2\" class=\"mw-headline\">Valutazione fisioterapica<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Physiotherapy Assessment\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=25\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Physiotherapy Assessment\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=25\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>La valutazione fisioterapica comprende l&#8217;anamnesi del paziente, l&#8217;esame obiettivo e i test speciali.<\/p>\n<h5><span id=\"Patient's_History_2\"><\/span><span id=\"Patient.27s_History_2\" class=\"mw-headline\">Anamnesi del paziente<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Patient's History\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=26\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Patient's History\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=26\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li>Descrizione dei sintomi (dolore)<\/li>\n<li>Impatto sulle attivit\u00e0 della vita quotidiana<\/li>\n<\/ul>\n<h5><span id=\"Physical_Examination_2\" class=\"mw-headline\">Esame obiettivo<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Physical Examination\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=27\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Physical Examination\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=27\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li>Osservazione\n<ul>\n<li>Osservare la postura del paziente in stazione seduta ed eretta: verificare la presenza di una postura leggermente flessa, di una posizione incurvata, con un&#8217;inclinazione verso il lato non affetto.<sup id=\"cite_ref-:9_28-0\" class=\"reference\"><a href=\"#cite_note-:9-28\">(28)<\/a><\/sup><\/li>\n<li>Osservare il paziente che cammina: osservare l&#8217;obliquit\u00e0 pelvica, la tendenza dell&#8217;anca a muoversi in adduzione durante la deambulazione.<sup id=\"cite_ref-:5_20-6\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><sup id=\"cite_ref-:13_29-0\" class=\"reference\"><a href=\"#cite_note-:13-29\">(29)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/ZUPQp5oxXj8?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-:13_29-1\" class=\"reference\"><a href=\"#cite_note-:13-29\">(29)<\/a><\/sup><\/p>\n<ul>\n<li>Palpazione:\n<ul>\n<li>Palpare la bandelletta ileotibiale e osservare la presenza di tensione, irritazione, dolore, trigger points.<sup id=\"cite_ref-:5_20-7\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Controllare la colonna lombare, le articolazioni sacroiliache, l&#8217;ischio, la cresta iliaca, l&#8217;aspetto laterale della borsa del grande trocantere, i ventri muscolari e la sinfisi pubica per determinare una potenziale fonte di sintomi o dolore all&#8217;anca.<sup id=\"cite_ref-:9_28-1\" class=\"reference\"><a href=\"#cite_note-:9-28\">(28)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Valutazione dell&#8217;escursione di movimento: controllare la flessione attiva dell&#8217;anca, la rotazione interna ed esterna, l&#8217;abduzione e l&#8217;adduzione. Il movimento pu\u00f2 riprodurre il dolore nella zona lesa.<\/li>\n<li>Valutazione della forza muscolare: valutare i principali gruppi muscolari che agiscono sull&#8217;articolazione dell&#8217;anca. La debolezza degli abduttori dell&#8217;anca \u00e8 un ritrovamento comune e la valutazione degli abduttori pu\u00f2 provocare dolore laterale all&#8217;anca durante l&#8217;esaminazione.<\/li>\n<li>Valutazione funzionale: mobilit\u00e0, passo. Cercare di individuare eventuali discrepanze nella lunghezza degli arti, debolezze e contatti del tallone che contribuiscono alla funzione del grande gluteo.<sup id=\"cite_ref-30\" class=\"reference\"><a href=\"#cite_note-30\">(30)<\/a><\/sup> L&#8217;incapacit\u00e0 di eseguire il test di indossare i calzini, che richiede al paziente di sedersi con una gamba incrociata nella posizione della figura 4, pu\u00f2 indicare che si stanno verificando cambiamenti nell&#8217;articolazione dell&#8217;anca. Questi cambiamenti possono portare all&#8217;osteoartrosi o alla borsite trocanterica.<\/li>\n<\/ul>\n<h5><span id=\"Special_Tests_2\" class=\"mw-headline\">Test speciali<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Special Tests\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=28\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Special Tests\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=28\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h5>\n<ul>\n<li>Jump Sign: paziente in decubito laterale, in modo che il lato interessato sia in alto, applicare una pressione intorno all&#8217;anca laterale o alla regione del grande trocantere.<sup id=\"cite_ref-:5_20-8\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup> Questo test ha un valore predittivo positivo di circa l&#8217;83% per la conferma della risonanza magnetica.<sup id=\"cite_ref-:5_20-9\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Test in appoggio monopodalico: il paziente deve stare in piedi su una gamba sola per 30 secondi. Il test \u00e8 positivo quando il paziente non \u00e8 in grado di mantenere l&#8217;equilibrio. Questo test ha un valore predittivo positivo quasi del 100% e conferma i reperti della risonanza magnetica.<sup id=\"cite_ref-:5_20-10\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Test FADIR<\/li>\n<li><a title=\"FABER Test\" href=\"\/FABER_Test\">Test FABER<\/a><sup id=\"cite_ref-:14_31-0\" class=\"reference\"><a href=\"#cite_note-:14-31\">(31)<\/a><\/sup><\/li>\n<li><a title=\"Ober's Test\" href=\"\/Ober%27s_Test\">Test di Ober<\/a><\/li>\n<li>Step Down and Step Up test<sup id=\"cite_ref-:15_32-0\" class=\"reference\"><a href=\"#cite_note-:15-32\">(32)<\/a><\/sup><\/li>\n<li><a class=\"mw-redirect\" title=\"Trendelenburg Test\" href=\"\/Trendelenburg_Test\">Test di Trendelenburg<\/a><\/li>\n<\/ul>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/X6trjwpyjdM?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-:14_31-1\" class=\"reference\"><a href=\"#cite_note-:14-31\">(31)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/uUUDSxcO5VY?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-:15_32-1\" class=\"reference\"><a href=\"#cite_note-:15-32\">(32)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Imaging_2\" class=\"mw-headline\">Immagini diagnostiche<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Imaging\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=29\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Imaging\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=29\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Ecografia: mostra una distensione della borsa del grande trocantere da parte di liquido anecoico o ipoecoico<sup id=\"cite_ref-33\" class=\"reference\"><a href=\"#cite_note-33\">(33)<\/a><\/sup><\/li>\n<li>Risonanza magnetica: non necessaria per diagnosticare la borsite trocanterica. Pu\u00f2 aiutare a confermare o escludere possibili diagnosi.<sup id=\"cite_ref-34\" class=\"reference\"><a href=\"#cite_note-34\">(34)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Management\/Interventions\"><\/span><span id=\"Management.2FInterventions\" class=\"mw-headline\">Gestione\/Interventi<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Management\/Interventions\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=30\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Management\/Interventions\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=30\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width: 352px;\"><a class=\"image\" href=\"\/File:Gluteal_tendinopathy_va_v12.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/bb\/Gluteal_tendinopathy_va_v12.png\/350px-Gluteal_tendinopathy_va_v12.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/bb\/Gluteal_tendinopathy_va_v12.png\/525px-Gluteal_tendinopathy_va_v12.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/b\/bb\/Gluteal_tendinopathy_va_v12.png\/700px-Gluteal_tendinopathy_va_v12.png 2x\" alt=\"\" width=\"350\" height=\"314\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p><small><i>Adapted from: Mellor R, Bennell K, Grimaldi A, Nicolson P, Kasza J, Hodges P, Wajswelner H, Vicenzino B., 2018. Education plus exercise versus cortico- steroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: a prospective, single-blinded, randomised clinical trial.<\/i><\/small><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Conservative_Management_2\" class=\"mw-headline\">Gestione conservativa<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Conservative Management\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=31\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Conservative Management\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=31\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>I rapporti della letteratura indicano che circa il 64% dei pazienti trova sollievo dopo un anno di terapia conservativa per la borsite trocanterica e il 71% dopo cinque anni. Esiste un&#8217;alta percentuale di recidiva dei sintomi della GTPS che richiede la ripetizione della terapia conservativa.<sup id=\"cite_ref-:16_35-0\" class=\"reference\"><a href=\"#cite_note-:16-35\">(35)<\/a><\/sup><\/p>\n<p><i>Obiettivo<\/i>: riduzione del dolore, miglioramento delle attivit\u00e0 funzionali.<\/p>\n<p>Fase acuta:<\/p>\n<ul>\n<li>Modifica dell&#8217;attivit\u00e0: riduzione dell&#8217;intensit\u00e0 e della frequenza della corsa, evitare di correre su superfici sconnesse o su piste inclinate<sup id=\"cite_ref-:4_19-2\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup><sup id=\"cite_ref-:5_20-11\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Modifica della posizione: dormire sul lato non interessato con un cuscino tra le ginocchia o sul fianco<sup id=\"cite_ref-:5_20-12\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Ghiaccio<sup id=\"cite_ref-:4_19-3\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup><sup id=\"cite_ref-:5_20-13\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>FANS orali (farmaci antinfiammatori non steroidei) e iniezioni di corticosteroidi e plasma ricco di piastrine (PRP)<sup id=\"cite_ref-:4_19-4\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup><sup id=\"cite_ref-36\" class=\"reference\"><a href=\"#cite_note-36\">(36)<\/a><\/sup><\/li>\n<li>Rilascio superficiale con terapia dei tessuti molli<sup id=\"cite_ref-:5_20-14\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Taping<sup id=\"cite_ref-:5_20-15\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Terapia a onde d&#8217;urto: pu\u00f2 essere utilizzata in circostanze particolari<sup id=\"cite_ref-:5_20-16\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><sup id=\"cite_ref-37\" class=\"reference\"><a href=\"#cite_note-37\">(37)<\/a><\/sup><sup id=\"cite_ref-38\" class=\"reference\"><a href=\"#cite_note-38\">(38)<\/a><\/sup><\/li>\n<li>Terapia a ultrasuoni: evidenze insufficienti<sup id=\"cite_ref-:5_20-17\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 202px;\"><a class=\"image\" href=\"\/File:3_quad_hip_abd_hep2go.JPG\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/ba\/3_quad_hip_abd_hep2go.JPG\/200px-3_quad_hip_abd_hep2go.JPG\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/b\/ba\/3_quad_hip_abd_hep2go.JPG\/300px-3_quad_hip_abd_hep2go.JPG 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/b\/ba\/3_quad_hip_abd_hep2go.JPG\/400px-3_quad_hip_abd_hep2go.JPG 2x\" alt=\"\" width=\"200\" height=\"206\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Esercizi di rinforzo per gli adduttori dell&#8217;anca<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Fase subacuta:<\/p>\n<ul>\n<li>Rinforzo degli adduttori dell&#8217;anca<sup id=\"cite_ref-:5_20-18\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Adductors_stretch.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a2\/Adductors_stretch.jpg\/300px-Adductors_stretch.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a2\/Adductors_stretch.jpg\/450px-Adductors_stretch.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/a\/a2\/Adductors_stretch.jpg\/600px-Adductors_stretch.jpg 2x\" alt=\"\" width=\"300\" height=\"200\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Allungamento degli adduttori<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Stretching degli adduttori<sup id=\"cite_ref-:5_20-19\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Modifica dell&#8217;attivit\u00e0: evitare l&#8217;adduzione dell&#8217;anca (incrociare le gambe)<sup id=\"cite_ref-:5_20-20\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<li>Modifica dell&#8217;esercizio: evitare gli esercizi di allungamento eccessivo dell&#8217;ITB<sup id=\"cite_ref-:5_20-21\" class=\"reference\"><a href=\"#cite_note-:5-20\">(20)<\/a><\/sup><\/li>\n<\/ul>\n<h4><span id=\"Surgical_Intervention_2\" class=\"mw-headline\">Intervento chirurgico<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Surgical Intervention\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=32\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Surgical Intervention\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=32\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>I casi di strappi degli adduttori o di patologia intra-articolare confermata dalla diagnostica per immagini che non rispondono bene alla gestione conservativa e spesso richiedono un intervento chirurgico.<sup id=\"cite_ref-:4_19-5\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup><\/p>\n<p><i>Obiettivo<\/i>: riduzione del dolore<\/p>\n<ul>\n<li>Bursectomia trocanterica con o senza rilascio della bandelletta ileotibiale: una buona opzione di trattamento nella tendinopatia di grado 1 e 2<sup id=\"cite_ref-:4_19-6\" class=\"reference\"><a href=\"#cite_note-:4-19\">(19)<\/a><\/sup><sup id=\"cite_ref-:17_39-0\" class=\"reference\"><a href=\"#cite_note-:17-39\">(39)<\/a><\/sup><\/li>\n<li>Allungamento o rilascio dell&#8217;ITB e della fascia lata (Z-plastica)<sup id=\"cite_ref-:16_35-1\" class=\"reference\"><a href=\"#cite_note-:16-35\">(35)<\/a><\/sup><\/li>\n<li>Osteotomia di riduzione trocanterica<sup id=\"cite_ref-:16_35-2\" class=\"reference\"><a href=\"#cite_note-:16-35\">(35)<\/a><\/sup><\/li>\n<li>Riparazione chirurgica per tendinopatia di grado 3 (strappi a spessore parziale) e 4 (strappi a spessore totale): evidenze di basso livello<sup id=\"cite_ref-:17_39-1\" class=\"reference\"><a href=\"#cite_note-:17-39\">(39)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span id=\"Resources\" class=\"mw-headline\">Risorse<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=33\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Resources\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=33\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Walker P, Ellis E, Scofield J, Kongchum T, Sherman WF, Kaye AD. <a class=\"external text\" href=\"https:\/\/orthopedicreviews.openmedicalpublishing.org\/article\/25088-snapping-hip-syndrome-a-comprehensive-update\" rel=\"nofollow\">Snapping Hip Syndrome: A Comprehensive Update<\/a>. Orthopaedic Reviews. 2021;13(2).<\/p>\n<p>Olufade O, Yoo A, Negron G, McDermott H, Jayanthi N. <a class=\"external text\" href=\"https:\/\/www.acquirepublications.org\/Journal\/Orthopedic\/PDF\/JOP2100102.pdf\" rel=\"nofollow\">Greater Trochanteric Pain Syndrome (GTPS): A clinical prospective study of treatment options<\/a>. J Orthop Pract. 2021;1(1).<\/p>\n<p>Pianka MA, Serino J, DeFroda SF, Bodendorfer BM. <a class=\"external text\" href=\"https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/20503121211022582\" rel=\"nofollow\">Greater trochanteric pain syndrome: Evaluation and management of a wide spectrum of pathology<\/a>. SAGE open medicine. 2021 Jun;9:20503121211022582.<\/p>\n<h2><span id=\"References\" class=\"mw-headline\">Citazioni<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;veaction=edit&amp;section=34\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Snapping_Hip_and_Trochanteric_Bursitis&amp;action=edit&amp;section=34\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:2-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_1-0\">1.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_1-1\">1.1<\/a><\/sup> <sup><a href=\"#cite_ref-:2_1-2\">1.2<\/a><\/sup> <sup><a href=\"#cite_ref-:2_1-3\">1.3<\/a><\/sup><\/span> <span class=\"reference-text\">Randelli F, Mazzoleni MG, Fioruzzi A, Giai Via A, Calvisi V, Ayeni OR. <a class=\"external text\" href=\"https:\/\/link.springer.com\/article\/10.1007\/s00167-020-06305-w#citeas\" rel=\"nofollow\">Surgical interventions for external snapping hip syndrome<\/a>. 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Orthopaedic Journal of Sports Medicine. 2021 Jul 29;9(7).<\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- \nNewPP limit report\nCached time: 20220708135610\nCache expiry: 0\nDynamic content: true\nComplications: ()\nCPU time usage: 0.313 seconds\nReal time usage: 0.341 seconds\nPreprocessor visited node count: 964\/1000000\nPost\u2010expand include size: 226\/2097152 bytes\nTemplate argument size: 0\/2097152 bytes\nHighest expansion depth: 3\/40\nExpensive parser function count: 0\/100\nUnstrip recursion depth: 0\/20\nUnstrip post\u2010expand size: 30428\/5000000 bytes\n--><br \/>\n<!--\nTransclusion expansion time report (%,ms,calls,template)\n100.00%   17.765      1 Special:Contributors\/Snapping_Hip_and_Trochanteric_Bursitis\n100.00%   17.765      1 -total\n--><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Redazione originale &#8211; Ewa Jaraczewska sulla base del corso di Rina Pandya Contributori principali &#8211; Ewa Jaraczewska, Jess Bell and Tarina van der Stockt Contenuti 1 Sindrome dell&#8217;anca a scatto 1.1 Sindrome dell&#8217;anca a scatto esterna 1.2 Sindrome dell&#8217;anca a scatto interna 1.3 Anca a scatto intra-articolare 1.3.1 Anatomia clinicamente rilevante 1.3.1.1 Bandelletta ileotibiale 1.3.1.2 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-1468","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/1468","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/comments?post=1468"}],"version-history":[{"count":18,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/1468\/revisions"}],"predecessor-version":[{"id":13565,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/1468\/revisions\/13565"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/media?parent=1468"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}