Trochanteric Bursitis

Aka: Trochanteric Bursitis, Greater Trochanteric Bursitis

1. Definition
   1. Inflammation of bursa overlying hip greater trochanter
2. Predisposing factors
   1. Chronic pressure or trauma to bursa
      1. Friction from overlying IT Band common in runners
   2. Leg Length Discrepancy
   3. Obesity
   4. Rheumatoid Arthritis
   5. Hip Osteoarthritis
   6. Hip ORIF with hardware causing irritation of bursa
   7. Lumbar Disc Disease
3. Symptoms
   1. Pain overlying greater trochanter
   2. May radiate into knee or ankle or into buttock
   3. Night pain occurs if lying on affected side
   4. Palliative and provocative factors
      1. Worse when standing from seated or lying position
      2. Improves initially on walking
      3. Worse again after walking for >30 minutes
4. Signs
   1. Point tenderness over lateral greater trochanter of hip
   2. Symptoms reproduced on hip adduction
   3. Adduction and internal rotation may also provoke
5. Radiology
   1. XRay lateral hip
   2. AP Pelvis
6. Differential Diagnosis
   1. Hip Osteoarthritis
   2. Septic hip
   3. Snapping Hip
   4. Trochanteric Fracture
   5. Gluteus medius Tendonitis
      1. Tenderness above greater trochanter
   6. Lumbar Disc Disease or Sciatica
      1. Affects foot, whereas bursitis does not
   7. Bony lesion (e.g. metastasis)
7. Management
   1. NSAIDs
   2. Modify activity
   3. Trochanteric Bursa Injection
8. References
   1. Greene (2001) Musculoskeletal Care, AAOS, p. 335-6
   2. Cardone (2003) Am Fam Physician 67(10):2147-52