Differential Diagnosis for Soft Tissue Clicking Movement over the Greater Trochanter

• Single Most Likely Diagnosis
  • Trochanteric Bursitis: This condition involves inflammation of the bursa over the greater trochanter, which can cause a clicking or snapping sensation due to the movement of the iliotibial (IT) band or other soft tissues over the bony prominence. The clicking is often accompanied by pain and tenderness in the area.
• Other Likely Diagnoses
  • Iliotibial (IT) Band Syndrome: Characterized by inflammation of the IT band, this condition can cause a clicking or snapping sensation as the band moves over the greater trochanter, especially during activities like running or cycling.
  • Gluteus Medius or Minimus Tendinopathy: Tendinopathy of these muscles can lead to snapping or clicking sensations due to the abnormal movement of the tendon over the greater trochanter.
• Do Not Miss Diagnoses
  • Osteonecrosis of the Femoral Head: Although less common, osteonecrosis can cause pain and potentially abnormal movement or clicking due to the structural changes in the bone. Missing this diagnosis could lead to significant morbidity if not addressed promptly.
  • Stress Fracture: A stress fracture in the proximal femur could potentially cause abnormal movement or clicking, especially if there is a significant displacement or if the fracture affects the surrounding soft tissues.
• Rare Diagnoses
  • Soft Tissue Tumors: Rarely, soft tissue tumors (benign or malignant) around the hip can cause abnormal movements or sensations, including clicking, due to their size and location affecting the movement of surrounding tissues.
  • Infectious Bursitis: An infection within the bursa over the greater trochanter can cause inflammation and potentially abnormal movement or clicking, though this would typically be accompanied by significant pain, redness, and swelling.