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Perspectives on orthopaedics

Trochanteric bursitis: misnomer and misdiagnosis

Michael J Walsh

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Abstract

Trochanteric pain of spontaneous onset in middle age is rarely due to bursitis. For patients with a degenerate tendon detachment or rupture, dramatic and substantial pain relief can be achieved by a successful repair.

Article Extract

Case presentation
History and examination

A 58-year-old woman presented with a three-year history of pain of gradual onset in the region of the left greater trochanter and no history of injury. This had been treated with a variety of conservative therapies, including physiotherapy and several corticosteroid injections, with little or no relief. She could not sleep on the affected side and her walking distance was limited to less than one kilometre by the pain. She was otherwise well, except for mild but well controlled hypertension.

Examination revealed a waddling gait (Trendelenburg lurch) on the left side and slight buttock wasting. There was weakness of hip abduction power, full pain-free hip mobility, and very marked tenderness over the greater trochanter.

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