Although trochanteric bursitis can occur in anyone, it is more common in women and in middle-aged people. In many cases, the cause of trochanteric bursitis is unknown; however, there are some known causes :

• Injury to the hip: A fall, bumping into things, or lying on one side of the body for extended periods of time.
• Repetitive stress to the hip: Repetitive climbing, cycling, running, climbing stairs, or standing for extended periods of time.
• Spine-related issues: Scoliosis and lumbar/lower spine degenerative changes are commonly associated with trochanteric bursitis.
• Stress on nearby soft tissue: such as due to leg-length differences leading to poor joint positioning.
• Other medical conditions: Rheumatoid arthritis, gout, psoriasis, thyroid disease, drug reactions, or even infections.
• Previous surgery around the hip joint.
• Extra bony growths, bone spurs, or mineral deposits in ligaments near the greater trochanter.

The main symptom of trochanteric bursitis is pain near the lateral (outside) aspect of the hip joint, in your outer thigh, or in your buttocks. Initially, this pain may be described as “sharp” or “intense;” later, the pain may become “achy” and spread to other areas near the hip. Additional symptoms may include:

• Pain that is worse at night
• Pain when lying on the affected side.
• Pain when pushing on the outside portion of the hip joint.
• Pain that worsens getting up from a seated position like out of a car or chair.
• Pain when walking upstairs.
• Pain that worsens with activities such as walking or cycling

Physical Exam

After obtaining a thorough history, a physical examination to assess range of motion, strength, and palpation of the painful hip region is the next step in diagnosis. Palpation may involve gently pressing on the affected area to check for tenderness, swelling, or warmth. This can help identify the specific location of pain and rule out other possible causes. A comprehensive physical exam is key to determine the cause of your hip pain and rule out other possible causes.

Imaging

In some cases, imaging studies may be ordered to confirm the diagnosis of trochanteric bursitis and rule out other conditions that could be causing pain over the lateral aspect of the hip. X-rays are often the initial imaging study done to rule out issues such as fracture or degenerative joint disease. While x-rays may not show bursitis directly, they can help rule out other causes of hip pain. Ultrasound imaging can provide real-time images of soft tissues like the bursa and can help identify signs of hip inflammation or fluid accumulation in the trochanteric bursa. An MRI may be recommended to gain detailed images of the hip area, including the bursa, gluteal tendons, hip labrum, and muscles.

Hip Injection

A greater trochanteric bursa hip injection can be both diagnostic and therapeutic. If most of your pain goes away, even temporarily, following the injection, then it confirms that the source of the pain is the trochanteric bursa. The injection can be performed in the office at the time of your visit or sometimes under ultrasound guidance.