What is trochanteric bursitis?
Trochanteric bursitis is an inflammation and irritation of the bursa of the lateral bone of the hip. The bursa is a sack full of fluid that acts as a cushion between the muscles, tendons, bones and joints.
There are two larger bags on the hip who typically suffer irritation and inflammation:
- A bag covers the bony protrusion of the hip bone, called the greater trochanter. The inflammation of this bag is trochanteric bursitis.
- Another bag, the psoas-iliac bag, is located on the inside of the hip. When this bag becomes inflamed, the condition is also called hip bursitis. However, pain occurs in the groin area. This condition is not so common, but it is treated in a similar way.
Risk factors and causes
Trochanteric bursitis can affect anyone. However, the incidence is more common in women and in middle-aged and elderly people.
There are a series of Risk factors that facilitate the appearance of this injury in the hip. Among them we can find:
- Injury due to repetitive overload or excessive use: This injury can occur when running, climbing stairs or other activities that require repetitive movements.
- Hip injury: When the hip is overloaded, it is easy for it to be injured. Also when you hit or lie on one side of it for a long period of time.
- Column disease: such as, for example, sclerosis, arthritis or other spinal problems.
- Difference in leg length: Many people have a difference in the length of their legs. This affectation, throughout affects the bursa of the hip.
- Surgery: Surgery around the hip or prosthetic implants in this joint can irritate the area and cause trochanteric bursitis.
- Bone spurs or calcium deposits: can develop in the tendons that join the muscles to the troncanter. They can affect the pouch and cause inflammation.
Symptoms of troncatheal bursitis
It is characteristic of troncarea bursitis the pain in the side of the hip, in the area of the major trunk. This pain can even extend through the upper part of the leg to reach the knee, following the path of the iliotibial band.
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This symptom it may be more intense when the patient lies down or sits on the side involved, when crossing the affected leg over another, when climbing stairs, after exercising or after a long time sitting or lying down.
Diagnosis of trochanteric bursitis
For the diagnosis of troncarea bursitis, the doctor will do a complete physical examination. Try to look for pain by feeling the affected area.
Further, it may also require the patient to perform other tests in order to rule out other injuries or possible complications. Among these tests are:
- X-rays: they are usually nonspecific. In 40% of the patients microcalcifications are detected on the trunk area or irregularities in the contour of the major trunk that do not seem to have clinical significance. It is useful to rule out coxopathy or an infectious strep throat.
- Tomography of bone: allows to objectify osseous alterations and parilesional calcareous deposits.
- Magnetic resonance: shows a non-specific high-intensity signal in the area of the major trunk.
- Sonographic techniques.
Treatment of trochanteric bursitis
Since the 1960s, the infiltration of glucocorticoids has been the treatment of choice for trochanteric bursitis.
However, We will see different types of treatment according to their methodology. In this sense there are non-surgical treatments and surgical treatments.
Many patients feel relief carrying out lifestyle changes for example:
- Modify the activity that worsens the symptoms
- Administration of medicines NSAIDs such as ibuprofen, to relieve inflammation and pain.
- Use assistive devices, such as the cane for walk.
Further, physical therapy is also useful. This will help strengthen and increase the flexibility of the hip.
And, finally, as we mentioned at the beginning, steroid injection is used, which is still the most effective treatment. However, it is important to limit the number of injections, since prolonged use can damage the surrounding tissues.
This type of treatment is reserved for the most serious cases. If the bag remains inflamed and continues to hurt after trying all the treatments mentioned above, the doctor can indicate that the best option is surgery.
Read also: What is bursitis? How is it treated?
The technique that is being used lately is the arthroscopic removal of the pouch. With this method, the bag is removed through a small incision in the hip, using an arthroscope or small camera.