Differential Diagnosis for Pain to Palpation at the Greater Trochanter
Single Most Likely Diagnosis
- Trochanteric Bursitis: This condition is characterized by inflammation of the bursa located at the greater trochanter, leading to pain and tenderness in the area. It is a common cause of lateral hip pain and is often related to repetitive friction or direct trauma to the area.
Other Likely Diagnoses
- Gluteus Medius Tendinopathy: Similar to trochanteric bursitis, gluteus medius tendinopathy involves inflammation of the tendon of the gluteus medius muscle, which attaches to the greater trochanter. This condition can cause pain and weakness in the hip area.
- Piriformis Syndrome: Although more commonly associated with sciatic pain, piriformis syndrome can also cause pain in the hip area, including the greater trochanter, due to the proximity of the piriformis muscle to this region.
- Greater Trochanteric Pain Syndrome (GTPS): This is a broader term that encompasses both trochanteric bursitis and gluteus medius tendinopathy, among other conditions, causing pain over the greater trochanter.
Do Not Miss Diagnoses
- Hip Fracture: Although less common, a fracture of the hip, particularly an intertrochanteric fracture, can present with pain to palpation at the greater trochanter. Missing this diagnosis could lead to significant morbidity.
- Osteonecrosis of the Femoral Head: This condition, also known as avascular necrosis, can cause hip pain that might be referred to the area of the greater trochanter. Early diagnosis is crucial to prevent collapse of the femoral head.
- Malignancy: Rarely, pain at the greater trochanter could be the first sign of a malignant process, such as a metastatic lesion to the bone or a primary bone tumor.
Rare Diagnoses
- Infection (Septic Bursitis or Osteomyelitis): Infection in the bursa or bone around the greater trochanter is a rare but serious condition that requires prompt diagnosis and treatment.
- Rheumatologic Conditions: Certain rheumatologic diseases, such as rheumatoid arthritis or systemic lupus erythematosus, can cause bursitis or tendinopathy around the greater trochanter, although this would typically be part of a more systemic presentation.