THE CONDITION
Trochanteric bursitis is inflammation of the trochanteric bursa. The trochanteric bursa sits on the side of the hip – helping as a lubricant for the movement of the muscles of the hip joint.
Occasionally, the bursa can become inflamed for no obvious reason. It is commonly seen in patients with rheumatoid arthritis, hip joint disorders, a tight iliotibial band or those who have suffered an injury. It is increasingly common with advancing age.
THE SYMPTOMS
Trochanteric bursitis typically causes pain felt in the outer thigh. This pain worsens with long walks,stair climbing or prolonged standing. The leg will be tender meaning that lying on the effected side often produces discomfort. Patient especially notice this at night. There may be associated muscle weakness causing a limp or an unsteadiness when on one leg. Most patients report a gradual onset of increasing discomfort over weeks or months, which fluctuates with activity levels.
THE DIAGNOSIS
The history taking and examination that will take place during your consultation will help with diagnosis. An ultrasound scan will be used to confirm the diagnosis and rule out other causes for your symptoms.
THE TREATMENT
This is a common condition that is confused with being an abnormality of the hip abductor muscles (gluteus medius and minimus). Ultrasound is very effective in distinguishing between the two conditions, and a diagnostic injection (usually a steroid) can be administered at the same time.
Most patients respond well to non-surgical treatments. The main treatment is sustained physiotherapy. Medications are often used such as a short course of anti-inflammatory tablets and intermittent steroid injections.
Surgery is usually considered only after other treatments have been attempted and proven ineffective. Most often, arthroscopic surgery (keyhole surgery) is used. The tight band of tissue on the side of the hip (iliotibial band) is released and the inflamed bursa removed.
If present, a torn or damaged abductor tendon can be repaired at the same time. Other effective treatments for trochanteric bursitis include Platelet Rich Plasma (PRP) injections, and extracorporeal shock wave therapy (ESWT).
PROGNOSIS
Recovery usually takes a number of months.
