Trochanteric Bursitis Flashcards
What is trochanteric bursitis?
Inflammation of the bursa over the greater trochanter
What are bursae?
Sacs created by synovial membrane filled with synovial fluid
What do bursae do?
Reduced friction between bones and soft tissues
What does bursitis lead to?
Thickening of the synovial membrane
Increased fluid production causing swelling
What causes bursitis?
Friction from repetitive movements
Trauma
Inflammatory conditions
Infection
How does trochanteric bursitis present?
Middle-aged
Gradual-onset lateral hip pain that radiates down outer thigh
Aching or burning pain
When is trochanteric bursitis worse?
With activity
Standing after sitting for a long period of time
Sitting cross-legged
On examination what is present with trochanteric bursitis?
Tenderness over greater trochanter
What special tests should be carried out to establish diagnosis?
Trendelenburg test
Resisted abduction of the hip
Resisted internal rotation of the hip
Resisted external rotation of the hip
Pain on resisted movement indicates bursitis as the bursa tighten
What do you do in Trendelenburg’s test?
Ask the patient to stand on one leg on the affected side
Pelvis should remain at the same height or raise slightly
If it drops this is a positive Trendelenburg
Why does the unaffected side dip in a positive Trendelenburg’s test?
Gluteus minimus and medius are responsible for stabilising the contra-lateral side, thus the non-affected side will dip
How is trochanteric bursitis managed?
RICE
Analgesia (NSAIDs)
Physiotherapy
Steroid Injections
What is a rare treatment of trochanteric bursitis?
Infection
Needs antibiotics
How long does it take to recover from trochanteric bursitis?
6-9 months
