Trochanteric Bursitis

        There are a lot of types of bursitis:

• Subacromial or Subdeltoid Bursitis
• Olecranon Bursitis or Elbow Bursitis
• Iliopsoas Bursitis
• Trochanteric Bursitis or Hip Bursitis
• Ischial Bursitis
• Prepatellar Bursitis or Housemaid knee or Kneecap Bursitis
• Infrapatellar Bursitis
• Pes anserine Bursitis or Knee Bursitis
• Calcaneal Bursitis

       There are three stages of bursitis: acute and chronic and recurrent. During the first phase the local inflammation and synovial fluid are diminished, causing painful joint movements. Chronic bursitis results in pain and causes weakening of tendons and ligaments. Bursitis affects especially oleocranon, subacromial, trochanteric, infrapatellar and prepatellar bursae. Localized tenderness, swelling, redness and reduce movement can represent bursa symptoms.

       If bursa is located superficially edema, local heat, redness and tenderness are observed. Patients with septic bursitis may present fever and local cellulite.

Trochanteric bursitis pictures

       Medical history should include:

• Localized tenderness
• Edema or erythema
• History of inflammatory diseases like systemic lupus erythematosus or rheumatoid arthritis or repetitive movements history
• Trauma

       Trochanteric bursitis have a superficial and a deep component. Runners and ballet dancers develop deep bursitis by usage. The disease is associated with rheumatoid arthritis of hip, osteoarthritis, and discrepancies between leg length. The area of the femur near the hip joint is called the trochanteric region, and is a very thickened area. Between muscles and bone are a number of packets used to facilitate the sliding of the muscles on bone.

Symptoms

       Pain usually occurs on the outside of the hip and may extend into the outer thigh to the knee. The pain usually increases when you press the area, this often happens when lying in bed on the affected side. Also walking, climbing stairs, squatting and stand for a period of time in the same position can cause pain.

Causes

       It is more common in women between 40 and 60. Among factors that may favor this disease are disorders of the same side of the lumbar spine and obesity. Other cause may be tendon ruptures.

Treatment

       You can start trochanteric bursitis treatment with anti-inflammatory and analgesic drugs and ultrasound, although in many cases these are ineffective. The steroid injections with local anesthetic often improve symptoms, although some symptoms may recur frequently. Surgery is the last option, and is cutting the sheath (fascia or ileotibial tract) of the hip muscles. Sometimes trochanteric bursitis surgery is used to rebuild inflamed tendons when these are the causes of pain.

       If palpation of the greater trochanter is painful, you should touch other areas of the hip and lateral thigh to see if they are sensitive. In trochanteric bursitis rest or decreased activity are recommended.

       The trochanteric bursitis is a common cause of hip pain resulting in inflammation of the bag interposed between the greater trochanter and fascia. In fact there are at least three bags in the hip region. The first one is located between the trochanter and fascia in the portion where the fibers converge two muscles, the gluteus maximus and tensor fascia. This bag is called the gluteus maximus. The second bag contains the glueus medium. The third bag, that of small buttock, is higher than the proximal portion of the greater trochanter. Each of these three bags can cause pain.

       In most patients bursitis tends to heal spontaneously or with the help of physical therapy and / or medical therapy. Only in chronic cases resistant to all these therapies, surgical treatment that can be performed arthroscopically. Treatment consists of removing the bag through two small incisions and a motorized instrument removes the diseased tissue.