Greater Trochanteric Bursa Injection

Excerpt

Greater trochanteric pain syndrome (GTPS) groups several etiologies of lateral hip, buttock, and thigh pain. These etiologies include greater trochanteric bursitis, gluteal medius tendinopathy or tears, gluteal minimus tendinopathy or tears, and iliotibial band snapping. Furthermore, patients may have coexisting bursitis and tendinopathy.

Greater trochanteric bursitis is characterized by localized lateral hip pain that typically presents with focal tenderness over the greater trochanter. The pain typically worsens when walking upstairs, standing up from a chair, or lying with the affected side down. The most common physical examination finding of greater trochanteric bursitis is pain with palpation over the greater trochanter; this is the key clinical diagnostic indicator differentiating greater trochanteric bursitis from primary diseases of the hip joint, which typically radiate towards the groin. The pain of greater trochanteric bursitis may be exacerbated by active abduction and passive adduction of the hip.

GTPS is more common in females, patients who are overweight or obese, and patients aged 40 to 60 years. It has been suggested that the larger width of the typical female pelvis may cause increased tension on the iliotibial band over the greater trochanter. In addition, patients with GTPS may have coexisting back pain, hip osteoarthritis, and conditions that alter lower extremity mechanics, such as knee pain resulting in abnormal forces around the hip. GTPS is diagnosed clinically and does not have specific diagnostic criteria. Imaging results are variable and may show bursitis, gluteal tendinopathy, or no bursal inflammation.