With an annual incidence of almost 2 in every 1,000 patients, trochanteric bursitis is an common inflammation of the tronchanteric bursa which cushions the hip bone, muscles and tendon of the thigh and buttocks.
What is trochanteric bursitis?
The tronchanteric bursa is located in the vicinity of the greater tronchanter of the femur bone of the thigh. Inflammation of this bursa is referred to as trochanteric bursitis and presents as tenderness in the hip area. The inflammation is typically unilateral. More commonly reported in the middle-aged and elderly, up to 50% of all cases are associated with degenerative disc disease and joint disease. Research also indicates women are four times more likely to be affected than men.
Signs and symptoms of trochanteric bursitis:
Also known as greater trochanteric pain syndrome (GTPS), the characteristic signs and symptoms of trochanteric bursitis include:
- tenderness on palpation of the greater tronchanter
- moderate to severe pain in the lateral hip region that does not involve hip joint itself;
- radiation of pain to thigh;
- swelling in the region of trochanteric bursa caused by the accumulation of fluid;
- aggravation of pain when lying or sleeping on the affected side;
- limitation of range of motion of the hip joint and performance of physical activities such as running, walking or even (if the bursitis is severe) standing.
How does trochanteric bursitis develop?
A bursa is a gelatinous sac containing fluid that serves to protect soft tissue from hard, bony surfaces. Bursae are concentrated in areas of tension and bony contact (i.e. shoulder joints, ankle joints, elbow joints) and act as the body’s shock absorbers.
Direct or indirect trauma to the bursa may lead to inflammatory changes that affect the integrity of soft tissue between greater trochanter and iliotibial tract. Chronic inflammation may lead to calcification of the bursa.
The following risk factors are strongly associated with the development of trochanteric bursitis:
- hip surgery (especially lateral hip) or long-standing inflammation of sacro-iliac joint;
- discrepancy of leg-length whether the result of trauma or surgery or a functional leg-length discrepancy which is created when one runs on banked surfaces. Note: The difference of one inch in leg length is enough to cause significant stress and pressure on the bursa of shorter leg;
- activities such as excessive running or jogging as part of a hobby or occupation; cycling; prolonged standing; frequent stair climbing;
- occupational injuries especially those received in contact sports or from frequent falls in activities such as ice hockey and skiing;
- repetitive injury of ilio-tibial band as a result of excessive stretching of the fascia lata
- long-standing disc degenerative conditions or arthritis of the hip joint;
- systemic diseases such as gout can also increase the risk of trochanteric bursitis.
- a sedentary lifestyle in which muscles and joints are not exercised can cause trochanteric bursitis to develop spontaneously.