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 antibiotics if infected bursa is suspected
Differential Diagnosis
Hip pain
Acute Trauma
- Femur fracture
- Proximal
- Intracapsular
- Extracapsular
- Shaft
- Mid-shaft femur fracture (all subtrochanteric)
- Proximal
- Hip dislocation
- Pelvic fractures
Chronic/Atraumatic
See Also
References
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