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Bursitis Trochanterica – Causes, Symptoms & Treatment

Bursitis trochanterica is an inflammation of the bursa located at the greater trochanter of the femur, causing pain on the outer side of the hip.

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Things worth knowing about "Bursitis trochanterica"

Bursitis trochanterica is an inflammation of the bursa located at the greater trochanter of the femur, causing pain on the outer side of the hip.

What is Bursitis Trochanterica?

Bursitis trochanterica, also known as greater trochanteric bursitis, is an inflammation of the bursa – a small, fluid-filled sac – located at the greater trochanter, the bony prominence on the outer side of the upper femur (thigh bone). Bursae reduce friction between tendons, muscles, and bones. When this bursa becomes inflamed, it causes characteristic pain along the outer hip that can significantly affect daily activities.

Causes

Bursitis trochanterica can be triggered by a variety of factors:

Repetitive mechanical stress: Overuse from sports, prolonged walking, or stair climbing
Direct trauma: A fall onto the hip or a direct blow to the greater trochanter
Muscle imbalances: Weakness or tightness of the hip muscles, particularly the iliotibial band
Leg length discrepancy: Unequal leg lengths leading to an altered gait pattern
Inflammatory conditions: Rheumatoid arthritis, gout, or other systemic inflammatory diseases
Infection: In rare cases, bacterial infection can cause septic bursitis

Symptoms

The hallmark symptom is pain on the outer side of the hip, which typically presents as:

Tenderness directly over the greater trochanter when pressed
Pain when lying on the affected side
Worsening pain during walking, climbing stairs, or prolonged sitting
Radiating pain down the outer thigh
Occasional swelling or warmth around the hip area

Diagnosis

Diagnosis is primarily based on a thorough clinical examination, during which the physician palpates the greater trochanter and assesses hip range of motion. Additional diagnostic tools may include:

Ultrasound (sonography): To detect fluid accumulation within the bursa
MRI (magnetic resonance imaging): Detailed visualization of soft tissue structures and exclusion of other pathologies
X-ray: To rule out bony abnormalities or calcifications
Laboratory tests: When a rheumatic or infectious cause is suspected

Treatment

Conservative Treatment

The majority of cases respond well to conservative management:

Rest and activity modification to reduce mechanical stress on the hip
Ice therapy: Application of cold packs to the affected area to reduce inflammation
Physiotherapy: Strengthening of the hip muscles and stretching of the iliotibial band
Non-steroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen or diclofenac for pain relief and inflammation reduction
Corticosteroid injection: Local injection of a corticosteroid into the inflamed bursa for rapid anti-inflammatory effect

Surgical Treatment

In chronic or treatment-resistant cases, a surgical procedure may be necessary. The inflamed bursa can be removed arthroscopically or through open surgery (bursectomy). Surgical intervention is, however, rarely required.

Prognosis

Bursitis trochanterica generally carries a favorable prognosis. With consistent treatment and physiotherapy, most patients experience significant improvement within weeks to months. Early intervention and avoidance of overloading activities help prevent a chronic course.

References

Sito, G. et al. – Trochanteric Bursitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK538503/
Lievense, A. et al. – Prognosis of trochanteric pain in primary care. British Journal of General Practice, 2005; 55(512): 199–204.
Del Buono, A. et al. – Management of the greater trochanteric pain syndrome: a systematic review. British Medical Bulletin, 2012; 102(1): 115–131.

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