What are the symptoms of trochanteric hip bursitis?

Symptoms of Trochanteric Hip Bursitis

Trochanteric bursitis presents with chronic, intermittent aching pain over the lateral aspect of the hip, with characteristic tenderness to palpation over the greater trochanter, particularly when lying on the affected side. 1

Primary Pain Characteristics

• Lateral hip pain is the hallmark symptom, localized to the greater trochanteric region 2, 1
• Pain is typically chronic and intermittent in nature, with an aching quality 1
• Tenderness over the greater trochanter is reproducible on physical examination and is a defining clinical feature 2, 3
• Pain is often worse when lying on the affected side during sleep 1

Radiation Patterns and Associated Symptoms

• Pain frequently radiates to the posterolateral aspect of the thigh, which can mimic other conditions 4, 3
• Some patients experience buttock pain as part of the symptom complex 3
• Paresthesias in the legs may occur, potentially mimicking nerve root compression syndromes 4
• Tenderness over the iliotibial tract is commonly present 4

Important Clinical Context

The diagnosis relies on the combination of lateral location of pain plus characteristic trochanteric tenderness, which are usually sufficient to reach a diagnosis after excluding lumbar spine or hip joint pathology 2. The condition most commonly affects patients between the fourth and sixth decades of life, though it can occur at any age 1.

Critical Diagnostic Pitfalls

• Symptoms can mimic major hip diseases, low back pain, and nerve root compression syndromes, making the diagnosis potentially elusive, especially with atypical presentations 1, 4
• The condition is frequently associated with chronic low back pain and sciatica, and patients with longstanding low back symptoms should be routinely checked for this syndrome 4
• Differentiation between true bursitis and gluteus medius/minimus tendinopathy can be difficult, as these conditions frequently coexist 5, 2
• The term "trochanteric bursitis" may be misleading, as evidence suggests that in the majority of cases, symptoms actually result from pathology of the gluteus medius or minimus muscles rather than the bursa itself 2

Functional Impact

• The condition causes pain and limitation of function that can significantly affect daily activities 1
• Symptoms are typically aggravated by activities that involve repetitive loading of the lateral hip structures 6