A bursa is a fluid filled sac of tissue which exists between a portion of a bone near the joint and the overlying skin and soft-tissues. The hip joint is surrounded by many bursa. The largest bursa around the hip joint occurs at the side of the femur around a bony prominence, called the greater trochanter, and is known as the trochanteric bursa.
Bursal sacs exist to prevent friction between the bone (which moves with hip motion) and the overlying skin (which does not move with hip range of motion). These bursal sacs are normally filled with a very small amount of fluid. If one of the bursal sacs gets irritated either by an injury or excessive friction (from the overlying tissues), the bursa becomes inflamed and filled with more fluid. This can lead to significant pain and tenderness in the area of the bursa. Trochanteric bursitis is a condition in which the trochanteric bursa becomes inflamed.
Signs & Symptoms:
Patients with trochanteric bursitis typically complain of pain at the side of their hip. The pain is often worse at night, especially if they sleep on their side. The side of the hip is usually very painful to the touch. Occasionally this pain will radiate down the outside of the thigh along the course of the iliotibial band (IT band).
The diagnosis of iliotibial band syndrome is usually made based upon the patient’s history and the findings on a thorough physical examination. X-rays are often performed to rule out other conditions, but usually are unremarkable.
Treatment for iliotibial band syndrome is usually non-operative in nature. Stretching exercises to decrease tension in the IT band are recommended. Physical therapy is prescribed to perform stretching exercises as well as to improve lower extremity mechanics. Icing the outside of the knee and anti-inflammatory medications are also useful to decrease pain and inflammation in the IT band.