trochanteric bursitis

Trochanteric bursitis results from the trochanteric bursa becoming irritated.

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 most commonly the cause of lateral hip pain is gluteal tendinosis .

Epidemiology

Affects approximately 6 per 1,000 population .

Clinical presentation

Patients often present with lateral hip pain that can radiate to the level of the knee. It is often tender to palpation as well, and worsens with the 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, e.g. gluteal tendinosis, iliotibial band thickening.

Pathology

Most common causes of trochanteric bursitis are:

• acute or chronic trauma
• tendon or muscle tear
• hematoma
• arthritis
• infection

Radiographic features

Ultrasound

• greater trochanteric bursa distended by anechoic or hypoechoic fluid

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 .

Differential diagnosis

• distal gluteus medius or minimus tear (partial- or full-thickness) or tendinosis
• iliotibial band thickening
• soft tissue tumor
• post-traumatic fluid collection (i.e. hematoma, seroma, lymphocele)
• Morel-Lavallée lesion

Siehe auch:

• greater trochanteric bursa
• Morel Lavallée Läsion
• iliotibial band thickening

und weiter:

• Bursitis