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
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.
| PHYSICAL EXAMINATION
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:
of your walking gait for abnormalities.
your hip through its full range of motion to detect
a crackling sensation.
of the joint to detect tenderness or swelling.
of your thighs to check for muscle atrophy.
pelvic and rectal examination to rule out tumors that
may cause pain in the hip.
of the back for evidence of disk herniation.
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.