Lower Limb Disorders - Greater Trochanter Bursitis

Question 1

What is Trochanteric Bursitis?

Answer 1

Inflammation of a bursa over the greater trochanter on the outer hip.

Question 2

What is a Bursa?

Answer 2

A sac created by a synovial membrane, filled with a small amount of synovial fluid.

Question 3

What is the function of a Bursa?

Answer 3

Reduce friction between the bones and soft tissues during movement - found at bony prominences.

Question 4

What happens to the Bursa during Bursitis?

Answer 4

Thickening of the synovial membrane and increased fluid production, causing swelling.

Question 5

Aetiology of Bursitis (4).

Answer 5

1. Friction from Repetitive Movements (fibroelastic iliotibial band).
2. Trauma.
3. Inflammatory Conditions e.g. RA.
4. Infection - Septic Bursitis.

Question 6

Stereotypical Patient in Trochanteric bursitis.

Answer 6

Middle-Aged Woman (50-70) with Gradual Onset Lateral Hip aching/burning Pain that may radiate down outer thigh.

Question 7

Clinical Presentation of Trochanteric Bursitis (5).

Answer 7

1. Greater Trochanteric Pain Syndrome - Pain and tenderness localised at the outer hip.
2. Pain may radiate down the outer thigh.
3. Pain is aching/burning.
4. Worse with activity, standing after sitting for long, trying to sit cross-legged.
5. Disrupt Sleep.

Question 8

Clinical Presentation of Septic Bursitis.

Answer 8

Warmth, Erythema, Swelling and Pain over Bursa.

Question 9

Examination Findings of Greater Trochanteric Bursitis (4).

Answer 9

1. Trendenlenburg Test Positive.
2. Resisted Abduction of Hip.
3. Resisted Internal Rotation of Hip.
4. Resisted External Rotation of Hip.

Question 10

Diagnosis of Greater Trochanteric Bursitis.

Answer 10

Clinical.

Question 11

Management of Greater Trochanteric Bursitis.

Answer 11

1. CONSERVATIVE : Rest, Ice, Analgesia, Physiotherapy and Steroid Injection.
2. Last Resort : Bursectomy.

Question 12

Management of Septic Bursitis and Prognosis.

Answer 12

Management : Antibiotics.

Prognosis : 6-9 Months.