Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Hip greater trochanteric bursitisGreater trochanteric pain syndrome (GTPS)Hip abductor pain syndrome ++ 726.5 Enthesopathy of the hip region ++ M70.6 Trochanteric bursitis ++ 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation +++ Description ++ Pain over the greater trochanter, lateral thigh pain2Differs from hip pointer (iliac crest contusion) based on location of injury/traumaPain on transition between standing and lying down Direct traumaFall onto lateral hip Direct blowIdiopathic2 +++ Essentials of Diagnosis ++ Friction between iliotibial band (ITB), bursa, and trochanterPressure from greater trochanter and overlying muscles compress bursa into the trochanter, creating pain and discomfortBursa is next to femur, between insertion of the gluteus medius and gluteus minimusFunctions as a shock absorber +++ General Considerations ++ Concern regarding possible slipped growth plate in younger childrenStress fractures or blood-supply disruption to the hip may appear later +++ Demographics ++ Common in runners +++ Signs and Symptoms ++ Audible or palpable snapping over lateral hip3Burning sensationPoint tender with palpationRadicular pain into buttock, down leg into kneeLimited motion adduction and internal rotationPain with rising up and down from chairSwellingRednessEcchymosis, if caused by direct trauma3During static weight bearing, patient may rotate femur to clear ITB from the greater trochanterPainful resisted hip external rotationPainful passive stretching of ITB, hip extension/flexionWeakness in hip abduction +++ Functional Implications ++ Antalgic gaitPainful end-ranges during ambulationPatient may increase weight bearing on the unaffected extremityPain and weakness as ITB passes over greater trochanterPain-limited functional activities (ADLs, physical and athletic activities)Difficulty sleeping on affected side +++ Possible Contributing Causes ++ TraumaPoor lower-extremity mechanics, (e.g., running mechanics, pronators)Tight hip adductorsHip musculature imbalanceITB tightnessWeak hip abductorsSacral dysfunctionOA of hip or lumbar spineDegenerative disk disease/low back painRheumatoid arthritisLeg-length discrepancy (true or perceived)FibromyalgiaPes planus ++ Osteoarthritis (OA)ITB syndromeFemoral head osteonecrosisFemoral-neck stress fractureLumbar disk herniationLumbar degenerative disc diseaseLumbar spinal stenosisHip arthritisSeptic arthritisHip avascular necrosisLumbar facet syndromeLumbar spine compression fractureAbductor muscle strainIschial or iliopectineal bursitisTendinitis of gluteus medius, gluteus maximusSnapping hip syndromeSciaticaMetastatic tumorInguinal and femoral hernia +++ Imaging ++ Radiographs of spine and hip MRI for soft tissue and fracture Bone scan for stress fracture and hip necrosisDiagnostic ultrasound ++ Positive Ober’s test2Radiographs negative +++ Medications ++ Corticosteroid injectionNSAIDsAcetaminophen ++ To hospital for imagingTo physician ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.