Orthopedics Book


  • Trochanteric Bursitis

Joint dislocation

Cardiovascular Medicine


Trochanteric Bursitis

Aka: Trochanteric Bursitis, Greater Trochanteric Bursitis, Greater Trochanteric Pain Syndrome
  1. Definitions
    1. Trochanteric Bursitis
      1. Inflammation of bursa overlying hip greater trochanter
    2. Greater Trochanteric Pain Syndrome (GTPS)
      1. Not an inflammatory condition
      2. Degenerative Tendinopathy of gluteus medius and gluteus minimus tendons
      3. Bursal distention may occur secondarily
  2. Epidemiology
    1. Most common cause of Lateral Hip Pain
    2. Greater Trochanteric Pain Syndrome (GTPS)
      1. Prevalence: 1.8 to 5.6 per 1000 adults/year
      2. Gender: More common in females by 4:1 ratio
      3. Peak ages 40-60 years old
  3. Causes
    1. Trochanteric Bursitis (less common than other causes)
    2. Gluteus Medius Tendinopathy
    3. Iliotibial band friction
    4. External Snapping Hip
  4. Predisposing factors
    1. Chronic pressure or Trauma to bursa
      1. Friction from overlying IT Band common in runners
      2. More common in runners with poor Running biomechanics (increased hip adduction)
    2. Leg Length Discrepancy
    3. Obesity
    4. Rheumatoid Arthritis
    5. Knee Osteoarthritis
    6. Hip Osteoarthritis
    7. Hip ORIF with hardware causing irritation of bursa
    8. Lumbar Disc Disease or Low Back Pain
  5. Symptoms
    1. Typically not associated with known causative injury
    2. Pain overlying greater trochanter
    3. May radiate into lateral thigh down to level or into buttock (non-radicular)
    4. Night pain occurs if lying on affected side
    5. Palliative and provocative factors
      1. Worse when standing from seated or lying position
      2. Worse with legs crossed
      3. Worse with direct pressure on the affected side (e.g. lying on that side)
      4. Improves initially on walking
      5. Worse again after walking for >30 minutes
  6. Signs
    1. Point tenderness over lateral greater trochanter of hip
    2. Symptoms reproduced on hip adduction
    3. Adduction and internal rotation may also provoke
    4. FABER Test also provokes pain
    5. Trandelenburg gait
  7. Radiology
    1. XRay lateral hip
    2. AP Pelvis
  8. 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)
  9. Management
    1. NSAIDs
    2. Modify activity
    3. Trochanteric Bursa Injection
    4. Consider gluteus Medius tear (MRI or Ultrasound)
    5. Consult orthopedic hip surgery
    6. Extracorporal shock wave therapy
  10. Prognosis
    1. Resolves with conservative management in 90% of patients
  11. References
    1. Greene (2001) Musculoskeletal Care, AAOS, p. 335-6
    2. Cardone (2003) Am Fam Physician 67(10):2147-52 [PubMed]
    3. Kane (2019) Am Fam Physician 100(3): 147-57 [PubMed]

Trochanteric bursitis (C0151451)

Concepts Disease or Syndrome (T047)
ICD10 M70.6, M70.60
SnomedCT 7674000
Dutch trochanter bursitis, bursitis; trochanterica, trochanterica; bursitis, Bursitis trochanterica
French Bursite trochantérienne
German Trochanterbursitis, Bursitis trochanterica
Italian Borsite trocanterica
Portuguese Bursite trocantérica
Spanish Bursitis trocantérica, bursitis trocantérea (trastorno), bursitis trocantérea
Japanese 大腿骨転子部滑液包炎, ダイタイコツテンシブカツエキホウエン
English bursitis trochanteric, trochanteric bursitis (diagnosis), trochanteric bursitis, Trochanteric bursitis, unspecified hip, bottom weavers, Trochanteric bursitis, Whirlbone lameness, Trochanteric bursitis (disorder), bursitis; trochanteric, trochanteric; bursitis, Bursitis;trochanteric
Czech Trochanterická burzitida
Korean 넓적다리돌기 윤활낭염
Hungarian Trochanter bursitis
Derived from the NIH UMLS (Unified Medical Language System)

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