Trochanteric bursitis
From Ganfyd
Responds to injection
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Painful inflammation of the bursa lateral and superficial to the greater trochanter of the femur.
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Aetiology
Often this is unclear. It may follow direct trauma, for instance in a fall, or excessive running.
Diagnosis
The pain may spread down the lateral aspect of the thigh, is related to movement, is likely to affect rest on that side in bed, and is reproduced by pressure over the femoral greater trochanter.
It would be unusual to perform any special investigations in reaching an initial diagnosis.
Treatment
It may improve with time. In runners and cyclists, attention to the ilio-tibial band and technique of the sport may be required.
Injection with local anaesthetic and steroid is a mainstay and seems effective. A diamond point needle would be ideeal, but a sufficiently long venepuncture needle is more usually to hand. Locate the greater trochanter, confirm the location of tenderness, and place the tip of the needle on the bone, drawing it back slightly before injecting either sequential LA and steroid, or a mixture. A volume of 5 ml with 40 mg of Depo-medrone diluted in 1% lidocaine is reasonable.
References
See also eMedicine
