Hip > Bursitis

What is Greater Trochanteric Bursitis?

Your joints have round, fluid–filled sacs, called bursa sacs, that provide lubrication at areas of friction between skin and underlying ligaments and bone. The hip region has several bursae. A common site of inflammation is the trochanteric bursa, which is located on the upper, outer area of your thigh over a bony protuberance called the greater trochanter.

Greater trochanteric bursitis is caused by chronic friction, from activities such as bicycling, running, or walking, or by any motion that alters your gait, such as a leg–length discrepancy or running on an uneven road surface. Diseases such as ankylosing spondylitis, psoriatic arthritis and gout can cause hip bursitis, as can sitting on a hard surface for prolonged periods.

If left untreated, hip bursitis can lead to increased discomfort when you walk, sit, or sleep, and a general loss of hip function due to decreased range of motion.

There are usually three parts to an orthopedic evaluation: medical history, physical examination, and tests your physician may order.

To help achieve an accurate diagnosis, your physician will ask you to describe your injury and symptoms, including the location, severity, and duration of your pain; what aggravates your pain and what you do to relieve it, and any history of previous trauma or treatment. You may also be asked about other medical conditions, such as diabetes and allergies, and medications currently being taken. Your physician may ask you about your physical and athletic goals – information that will help your physician decide what treatment might be best for you in achieving those goals.

Since your hip is composed of a thatchwork of muscles, ligaments, cartilage, nerves, and bone, your physician may use any of a number of physical tests to diagnose bursitis. These can include the following:

   Observation of your walking gait for abnormalities.

   Putting your hip through its full range of motion to detect a crackling sensation.

   Manipulation of the joint to detect tenderness or swelling.

   Comparison of your thighs to check for muscle atrophy.

   A pelvic and rectal examination to rule out tumors that may cause pain in the hip.

   Examination of the back for evidence of disk herniation.

   A neurologic examination to test for weakness, sensory loss, and reflexes.

Several imaging tests can be used to aid in diagnosis of hip bursitis. X–rays allow your physician to view bony changes and joint space narrowing. Magnetic resonance imaging (MRI) can detect bone fractures and changes in soft tissue such as cartilage. Your physician also may perform a blood test to rule out infection, gout, or pseudogout, all of which are common sources of joint–related pain. If infection in the joint is suspected, fluid may be drawn out with a needle for microscopic analysis. If a bacterial infection is present, treatment with antibiotics would be required.

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