Hip bursitis

Trochanteric Bursitis

Background

• Trochanteric bursa lies between gluteus maximus and posterolateral greater trochanter
• Most common in female runners and elderly women (rheumatoid arthritis)

Clinical Features

• Pain when lying on affected side
• Pain worsened by walking and climbing stairs
• Pain over greater trochanter (posterolateral hip pain)
• Pain to resisted abduction or adduction of hip

Iliopsoas Bursitis

Clinical Features

• Pain with extension of hip
• Tenderness over middle third of inguinal ligament in area of femoral pulse

Ischial Bursitis

Background

• Occurs most often in sedentary patients who sit on a hard surface for long periods of time

Clinical Features

• Pain is present over the ischial prominence
• Pain is increased in the sitting position

Iliopectineal Bursitis

Background

• Bursa is interposed between the hip joint and iliopsoas muscle

Clinical Features

• Pain sensed over the anterior pelvis and groin on the affected side
• Increased pain with hip extension

Management

• NSAIDs, rest, heat
• Admit for IV antibiotic if infected bursa is suspected

Differential Diagnosis

Hip pain

• Femur fracture
• Hip dislocation
• Hip bursitis
• Psoas abscess
• Piriformis syndrome
• Meralgia paresthetica
• Septic Arthritis (Hip)
• Obturator nerve entrapment
• Pelvic fractures
  • Acetabular pelvic fractures
  • Open book pelvic fracture
  • Straddle pelvic fracture
  • Pelvic avulsion fracture
• Avascular necrosis of hip

See Also

Bursitis

References

Authors

Jordan Swartz, Ross Donaldson, Neil Young, Daniel Ostermayer