Trochanteric Bursitis
Overview: Pain or discomfort found around the greater trochanter in the upper lateral thigh. Usually described as a dull or ache but can be be sharp. Symptoms may also radiate down the side of the leg.
Causes/Risk Factors/Pathogenesis: Abnormal friction created between the bursa around the trochanter and surrounding tissue. Friction leads to inflammation of bursa and surrounding tissues.
Tight ITB
Running
Leg length discrepancy
Weak hip abductors and internal rotators
Lumbopelvic dysfunction
Contraindications/Precautions: Assess bone, hip joint, and lumbosacral dysfunction before performing special tests for bursitis. Integumentary findings of swelling, redness, and warmth in the greater trochanteric area indicate more serious pathology.
Examination:
--History: Typically gradual onset of diffuse ache, discomfort, and pain in the area and possibly becoming sharp and severe. Stiffness, soreness, and discomfort reported more with movement. May or may not have trauma related history. Knee pain may also be present. Symptoms are aggravated by activity (especially involving flexion and external rotation), prolonged standing, ascending inclines like hills or stairs, and external pressure on the area.
-Past Hx, Family Hx, Meds, Recurrent Illnesses: Unremarkable.
--Diagnostic Tests: Ober's test
Trendelenburg test
Resisted hip abduction resulting in pain
Differential Diagnosis Tests:
Patrick's test - hip joint pathology
Observation and palpation for redness, swelling, and warmth for more serious pathology
SLR for lumbopelvic referral
--Tests and Measures: Palpation for specific tenderness at the mid-trochanteric and/or superior-trochanteric area
Leg length discrepancy
Gait observation
MMT of hip abductors and internal rotators
--Imaging: Imaging is typically negative and used to rule out more serious pathology.
See Trochanteric Bursitis References
Causes/Risk Factors/Pathogenesis: Abnormal friction created between the bursa around the trochanter and surrounding tissue. Friction leads to inflammation of bursa and surrounding tissues.
Tight ITB
Running
Leg length discrepancy
Weak hip abductors and internal rotators
Lumbopelvic dysfunction
Contraindications/Precautions: Assess bone, hip joint, and lumbosacral dysfunction before performing special tests for bursitis. Integumentary findings of swelling, redness, and warmth in the greater trochanteric area indicate more serious pathology.
Examination:
--History: Typically gradual onset of diffuse ache, discomfort, and pain in the area and possibly becoming sharp and severe. Stiffness, soreness, and discomfort reported more with movement. May or may not have trauma related history. Knee pain may also be present. Symptoms are aggravated by activity (especially involving flexion and external rotation), prolonged standing, ascending inclines like hills or stairs, and external pressure on the area.
-Past Hx, Family Hx, Meds, Recurrent Illnesses: Unremarkable.
--Diagnostic Tests: Ober's test
Trendelenburg test
Resisted hip abduction resulting in pain
Differential Diagnosis Tests:
Patrick's test - hip joint pathology
Observation and palpation for redness, swelling, and warmth for more serious pathology
SLR for lumbopelvic referral
--Tests and Measures: Palpation for specific tenderness at the mid-trochanteric and/or superior-trochanteric area
Leg length discrepancy
Gait observation
MMT of hip abductors and internal rotators
--Imaging: Imaging is typically negative and used to rule out more serious pathology.
See Trochanteric Bursitis References