The most likely diagnosis for lateral hip pain with tenderness over the greater trochanter is which condition?

The most likely diagnosis for lateral hip pain with tenderness over the greater trochanter is which condition?

• A. Trochanteric bursitis
• B. Iliotibial band syndrome
• C. Gluteus medius tendon tear
• D. Hip osteoarthritis

Answer: (A)

Lateral hip pain with tenderness directly over the greater trochanter points to inflammation of the trochanteric bursa that sits over that bony prominence. The trochanteric bursa smooths the gliding of the gluteus medius and minimus tendons as they move over the greater trochanter, so when it becomes inflamed from overuse, repetitive hip motion, or trauma, you get localized tenderness at the greater trochanter and pain with hip movement or when lying on the affected side. Iliotibial band syndrome usually causes friction-related pain along the outer thigh or knee, not a focused tender point at the greater trochanter. Gluteus medius tendon tear can cause lateral hip pain and may show weakness with hip abduction and a trendelenburg gait, but the hallmark is weakness and gait change rather than isolated tenderness over the bursa. Hip osteoarthritis tends to produce groin or anterior thigh pain with stiffness and reduced internal rotation, not focal greater trochanter tenderness. So the presentation most consistent with trochanteric bursitis is localized tenderness over the greater trochanter with lateral hip pain.

Lateral hip pain with tenderness directly over the greater trochanter points to inflammation of the trochanteric bursa that sits over that bony prominence. The trochanteric bursa smooths the gliding of the gluteus medius and minimus tendons as they move over the greater trochanter, so when it becomes inflamed from overuse, repetitive hip motion, or trauma, you get localized tenderness at the greater trochanter and pain with hip movement or when lying on the affected side.

Iliotibial band syndrome usually causes friction-related pain along the outer thigh or knee, not a focused tender point at the greater trochanter. Gluteus medius tendon tear can cause lateral hip pain and may show weakness with hip abduction and a trendelenburg gait, but the hallmark is weakness and gait change rather than isolated tenderness over the bursa. Hip osteoarthritis tends to produce groin or anterior thigh pain with stiffness and reduced internal rotation, not focal greater trochanter tenderness.

So the presentation most consistent with trochanteric bursitis is localized tenderness over the greater trochanter with lateral hip pain.