GREATER TROCHANTERIC BURSITIS                                KANDIL NOTES

INTRODUCTION

  • Greater trochanteric bursitis is a painful condition caused by inflammation of one of the hip bursae

  • A bursa is a fluid filled sac that serves as a lubricant between muscles/tendons to allow for smooth frictionless motion

  • When irritated, the bursa inflames and becomes filled with fluid, thereby causing pain 

  • CAUSES

  • There are many potential causes for greater trochanteric bursitis. Most commonly, it is due to repetitive activity involving the hip tendons rubbing against each other and leading to inflammation

  • Other causes include direct trauma or fall on the hip, tendinopathy of surrounding tendons, or idiopathic with no known cause

  • SIGNS AND SYMPTOMS

  • Patients with greater trochanteric bursitis have pain in the lateral or outer part of the hip 

  • They often report tenderness to palpation over the outer hip and pain with repetitive hip motion

  • TREATMENT​​

  • A course of rest, ice, anti-inflammatories, aggressive IT band stretching, and a home exercise program is the mainstay of treatment for greater trochanteric bursitis

  • Cortisone injections may be an option in patients with significant trochanteric bursitis

  • In patients who fail above modalities, platelet rich plasma (PRP) injections may be considered

  • A recent Level, I systematic review of available randomized clinical trials and case series in the literature noted improvement in patients at 3- and 12-month follow up

  • Surgery is considered in patients with failure of extensive conservative management

  • Surgery consists of bursa excision and can be done endoscopically

        PREVENTION

  • Strengthening and stretching the hip musculature, avoiding repetitive hip motions, and warming up prior to physical activity can help decrease the chance of greater trochanteric bursitis

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