Trochanteric bursitis results from irritation of the trochanteric bursa.
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Terminology
Previously trochanteric bursitis has been attributed as the major cause of lateral hip pain but now the term greater trochanteric pain syndrome is preferred because the most common cause of lateral hip pain is gluteal tendinosis 1,3.
Epidemiology
It affects approximately 6 in 1000 people 1.
Clinical presentation
Patients often present with lateral hip pain that can radiate to the level of the knee. It is often tender to palpation and worsens with inciting activity. Pain can often be elicited during physical exam with passive external rotation.
These symptoms are non-specific and may represent other pathology in this region such as gluteal tendinosis or iliotibial band thickening.
Pathology
The most common causes of trochanteric bursitis are:
acute or chronic trauma
tendon or muscle tear
hematoma
arthritis
infection
Radiographic features
Ultrasound
The greater trochanteric bursa is typically distended by anechoic or hypoechoic fluid 4.
MRI
T1: corresponding region of low signal
T2: bursa is enlarged and of high signal
T1 C+ (Gd): peripheral rim enhancement
Treatment and prognosis
Trochanteric bursitis is generally self-limiting and responds to conservative treatment. Refractory cases may be treated with corticosteroid injection or surgery 1.
Differential diagnosis
distal gluteus medius or minimus tear (partial or full thickness) or tendinosis
iliotibial band thickening
post-traumatic fluid collection (i.e. hematoma, seroma, lymphocele)