Trochanteric bursitis: the last great misnomer

Area of Science:

• Orthopedics
• Rheumatology
• Histopathology

Background:

• Trochanteric bursitis is a common diagnosis for lateral hip pain.
• The term is often used broadly, potentially encompassing various underlying pathologies.

Purpose of the Study:

• To investigate the presence of inflammation in the trochanteric bursa of patients diagnosed with trochanteric bursitis.
• To challenge the traditional understanding of trochanteric bursitis as an inflammatory condition.

Main Methods:

• Prospective, case-controlled, blinded study involving 50 patients undergoing primary total hip replacement.
• Histological analysis of intraoperatively harvested trochanteric bursal samples from 25 patients with diagnosed trochanteric bursitis (group A) and 25 controls (group B).
• Intraoperative assessment of abductor tendon insertion.

Main Results:

• No histological evidence of acute or chronic inflammation was found in any bursal samples from either group.
• Thinning of the gluteus medius tendon was observed in 20% of patients in group A.
• No macroscopic tendon tears were detected in the bursal samples.

Conclusions:

• The findings cast doubt on the inflammatory nature of 'trochanteric bursitis'.
• The study suggests that trochanteric bursitis may not be a distinct clinical entity.
• Alternative causes for lateral hip pain should be investigated.