Trochanteric bursitis

Last revised by Joshua Yap on 2 Feb 2024

Trochanteric bursitis results from irritation of the trochanteric bursa.

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.

It affects approximately 6 in 1000 people 1

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.

The most common causes of trochanteric bursitis are:

  • acute or chronic trauma

  • tendon or muscle tear

  • hematoma

  • arthritis

  • infection

The greater trochanteric bursa is typically distended by anechoic or hypoechoic fluid 4.

  • T1: corresponding region of low signal

  • T2: bursa is enlarged and of high signal

  • T1 C+ (Gd): peripheral rim enhancement

Trochanteric bursitis is generally self-limiting and responds to conservative treatment. Refractory cases may be treated with corticosteroid injection or surgery 1

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Cases and figures

  • Case 1: MRI
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  • Case 2: with abductor tear
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  • Case 3a: ultrasound
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  • Case 3b: ultrasound-guided steroid injection
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  • Case 4: post-traumatic
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