This book describes Trochanteric Bursitis, Diagnosis and Treatment and Related Diseases
Trochanteric bursitis is the inflammation of the bursa (fluid-filled sac near a joint) at the part of the hip termed the greater trochanter.
When this bursa is irritated or inflamed, it produces pain in the hip.
This is a frequent cause of hip pain.
Trochanteric bursitis can happen from one or more of these events:
Injury to the point of the hip
This can involve falling onto the hip, hitting the hip into an object, or lying on one side of the body for a prolonged period of time.
Play or work activities that cause overuse or injury to the joint areas
Such activities might involve running up stairs, climbing, or standing for long periods of time.
Incorrect posture
This disorder can be produced by scoliosis, arthritis of the lumbar (lower) spine, and other spine disorders.
Stress on the soft tissues
Stress can occur on the soft tissues of the hip as a result of an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint).
Other diseases or disorders
These may involve rheumatoid arthritis, gout, psoriasis, thyroid disease or an abnormal drug reaction.
In rare cases, bursitis can happen from infection.
Previous surgery
Previous surgical procedures around the hip or prosthetic implants in the hip may affect the bursa.
Hip bone spurs or calcium deposits
The tendons that attach to the trochanter may have bony spurs or calcium deposits that irritate the bursa.
Bursitis is more frequent in women and in middle-aged or elderly people.
Symptoms
Pain on the outside of the hip and thigh or in the buttock.
Pain when lying on the affected side.
Pain when the patient presses in or on the outside of the hip.
Pain that gets worse during activities such as getting up from a deep chair or getting out of a car.
Pain with walking up stairs.
Diagnosis
The diagnosis of bursitis of the hip is normally based on medical evaluation.
To diagnose hip bursitis, the doctor upon reviewing the history of the location of the hip pain and specific areas of tenderness of the outside of the hip will do a comprehensive physical examination, looking for tenderness in the area of the point of the hip.
This can be further verified when a local injection of anesthetic alleviates the pain.
Patients often notice pain in the outer hip with stair climbing or descending and tenderness of the hip when lying on the involved side at night.
The doctor can localize the tender areas to the site of the bursa of the hip.
Occasionally, X-ray of the hip is utilized to exclude other disorders of the bone and joints, such as arthritis and also pinpoint areas of calcium deposits in an inflamed bursa.
These areas of calcification suggest a past history of inflammation of the bursa.
He or she may also do additional tests to exclude other possible injuries or disorders.
These tests can be imaging studies, such as x-rays, bone scanning, and magnetic resonance imaging (MRI).
Treatment
Treatment goals are reducing pain and inflammation (swelling), preserving mobility, and preventing disability and repeat occurrence.
The treatment advices may involve a combination of rest, splints, heat and cold application.
More advanced treatment methods are:
Non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen.
Corticosteroid injections given by the doctor
Injections work rapidly to reduce the inflammation and pain.
Physical therapy that involves range of motion exercises and splinting.
This can be very beneficial.
Surgery, when other treatments are not successful.
Surgery is rarely required for hip bursitis.