Greater Trochanteric Bursitis

Anatomy

The hip joint is the junction between the femur (thigh) bone and the pelvis and is referred to as a ball and socket joint. The bony prominence on the outside of the hip is the greater trochanter of the femur. There is a muscle that originates on the outside of the pelvis called the Tensor Fascia Lata (TFL) and becomes a very long tendon near the greater trochanter. This tendon runs all along the side of the thigh and inserts on the tibia (shin bone). Since this tendon spans from the ischium of the pelvis, down to the tibia it is called the iliotibial (IT) band. The space between the greater trochanter of the femur and the iliotibial band is known as a bursa. 

What is Greater Trochanteric Bursitis?

Greater trochanteric bursitis is Inflammation of the bursa between the greater trochanter of the femur and the iliotibial band. It can occur from either trauma to the side of the hip or from repetitive motions like running. It is more common in females than males.

Symptoms of Greater Trochanteric Bursitis

• Lateral hip pain (pain on the outside of the hip)
• Pain will often wake people up at night if laying on that side
• Pain may also be present when laying on the other hip due to stretching the iliotibial band over the inflamed bursa
• Pain when pushing on the outside of the hip

Diagnosing Greater Trochanteric Bursitis

Greater trochanteric bursitis is usually diagnosed with clinical history and exam including pain with palpation over the outside of the hip over the greater trochanter. X-rays are usually not helpful but an MRI can show increased signal in the bursa.

Treatment for Greater Trochanteric Bursitis

• Activity modifications and rest
• Anti-inflammatory medications
• Physical therapy
• Injections

• Done either open or endoscopically (through small incisions) in which the inflamed bursa is removed. In some cases, the iliotibial band may be lengthened as well