Hip Bursitis

What is hip bursitis?

Hip bursitis is a common problem that causes pain over the outside of the upper thigh. A bursa is a fluid filled sac that allows smooth motion between two uneven surfaces. For example, in the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passed over this bone. When the bursal sac becomes inflamed, each time the tendon has to move over the bone, pain results. Because patients with hip bursitis move this tendon with each step, hip bursitis symptoms can be quite painful.

What causes hip bursitis?
Hip bursitis can be associated with different types of patients:

• Athletes
  Hip bursitis is commonly seen in runners or athletes who participate in running-oriented sports (e.g. soccer, football, etc.).

• Injuries
  Hip bursitis is sometimes associated with patients who fall onto their upper thigh, causing a so-called traumatic bursitis. The symptoms are similar to a hip pointer.

• Post-surgical
  Patients who have had surgery, such as hip fracture surgery, or total hip replacement, may complain of pain over the outside of the hip. These symptoms are often due to irritation to the bursa causing hip bursitis.

How is hip bursitis diagnosed?
The diagnosis of hip bursitis is made most reliably on physical examination. The most common symptoms of hip bursitis include:

• Tenderness over the bony prominence of the upper/outer thigh

• Swelling over the bursa

An x-ray is often obtained to ensure there are no bone spurs or calcifications that could be contributing to the problem. Occasionally, your doctor may obtain an MRI if the diagnosis is unclear or if the problem does not resolve with treatment.

What else can cause symptoms similar to hip bursitis?
As with any medical condition, other problems that can cause similar symptoms should be considered. Hip bursitis is usually a clear diagnosis, and the symptoms can be distinguished from other conditions. However, some cases of hip bursitis can be confused with other medical conditions. These include:

• Iliotibial band tendonitis

• Hip pointers

• Meralgia paresthetica

• Low-back conditions

These are the most common causes of pain over the upper/outer thigh, other than hip bursitis. Other causes of pain in this area include hip joint problems, such as arthritis and labral tears, but these usually cause symptoms in areas other than the outside of the thigh.