Bursitis at the outer femoral bone projection

Anatomy: On the outside of the outer femoral bone projection (trochanter major) is a large bursa which reduces the load on muscles and tendons when these slide over the bone projection.

Symptoms: Pain when applying pressure on the thigh corresponding to the bursa, which sometimes (but far from always) can feel swollen. The pain can radiate down the thigh.

Acute treatment: Click here.

Examination: In light cases with only minimal tenderness medical examination is not necessarily required. In case of more pronounced pain or lack of progress, a medical examination should be carried out to ensure the diagnosis and commencement of any treatment. A normal medical examination is usually sufficient in order to make the diagnosis, however, if there is any doubt concerning the diagnosis an ultrasound scan can be performed (Ultrasonic image).

Treatment: The treatment primarily comprises relief. If the direct cause of the complaint is known, it should of course be removed. The treatment can be supplemented with rheumatic medicine (NSAID) or injection of corticosteroid in the bursa, which is best performed under the guidance of ultrasound.

Complications: If progress is not smooth, the correctness of the diagnosis should be considered or whether complications have arisen:

• Tendinitis at the sitting (ischiatic) bone
• Rupture of the rear femoral muscle fastening on the sitting (ischiatic) bone
• Piriformis syndrome
• Degenerative arthritis in the hip joint
• Rupture of the superficial hip flexor (ruptura musculus rectus femoris)
• Rupture of the deep hip flexor (ruptura musculus iliopsoas)
• Outer snapping hip
• Inner snapping hip
• Fluid accumulation in the joint (traumatic synovitis/coxitis)
• Stress fracture of the femoral neck

Special: Shock absorbing shoes or inlays will reduce the load. In case of lack of progress or recurrences after successful rehabilitation it can be considered to have a running style analysis, to evaluate whether correction of the running style is indicated.