- Trochanteric bursitis
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ICD10 = ICD10|M|70|6|m|70
ICD9 = ICD9|726.5
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MeshID =Trochanteric bursitis is inflammation of the trochanteric bursa.
This bursa is situated adjacent to the femur, between the insertion of the
gluteus medius andgluteus minimus muscles into the greater trochanter of thefemur and the femoral shaft. It has the function, in common with other bursae, of working as a shock absorber and as a lubricant for the movement of the muscles adjacent to it.Occasionally, this bursa can become inflamed and clinically painful and tender. This condition can be a manifestation of
rheumatoid arthritis or of an injury, but sometimes arises for no obviously definable cause. The symptoms are pain in the hip region on walking, and tenderness over the upper part of the femur, which may result in the sufferer being unable to lie in comfort on the affected side.More often the lateral hip pain is caused by disease of the gluteal tendons which secondarily inflames the bursa. This is most common in middle age women and is associated with a chronic and debilitating pain which does not respond to conservative treatment.
Treatment
The primary treatment is rest. This does not mean
bed rest or immobilizing the area but avoiding actions which result in aggravation of the pain. Taking anti-inflammatory medications may relieve pain and reduce the inflammation, however, if these are ineffective, the definitive treatment is steroid injection into the inflamed area. Other treatment options may include applying an ice pack over the tender area or visiting a physiotherapist for other conservative treatments.In extreme cases, where the pain does not improve after physical therapy,
cortisone shots, and anti-inflammatory medication, the inflamed bursa can be removed surgically. The procedure is known as abursectomy . The bursa is not required, so the main potential complication is potential reaction to anaesthetic. The surgery can be performed arthroscopically and, consequently, on an outpatient basis. Patients often have to use crutches for a few days following surgery. At the time of bursal surgery, a very close examination of the gluteal tendons will reveal sometime subtle and sometimes very obvious degeneration and detachment of the gluteal tendons. If this detachment is not repaired, removal of the bursa alone will make little or no difference to the symptoms.References
Hip Bursitis at about.com [http://orthopedics.about.com/cs/hipsurgery/a/hipbursitis.htm]
Bursitis surgery at orthogate.com [http://www.orthogate.org/patient-education/hip/trochanteric-bursitis-surgery.html]
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