To diagnose hip bursitis, a doctor must rule out other problems that could cause outer hip pain, such as hip osteoarthritis, tendonitis, snapping hip syndrome, iliotibial band syndrome, and conditions affecting the low back.
It's sometimes called “the great mimicker” because its symptoms are easily mistaken for other conditions like back pain or gluteal muscle injuries.
Sometimes an infection in the bursa or tendon will cause the area to be inflamed. Tendonitis or bursitis may be linked to other conditions. These include rheumatoid arthritis, gout, psoriatic arthritis, thyroid disease and diabetes.
Because bursitis and tendonitis pain may be felt near the joints, it is sometimes mistaken for arthritis. Knowing the differences between these conditions can help you identify and address the root cause of your joint pain to get you back to an active life.
Ultrasound and MRI specifically are used to confirm the diagnosis when the bursae are too deep for regular inspection.
Doctors examine the affected area to look for swelling, redness, or warmth. They also feel for bumps beneath the skin, which may indicate swollen bursae. Doctors use their hands to gently move the affected part of the body to see if bursitis or tendinitis are limiting range of motion or causing pain.
Diagnosing hip bursitis
Your doctor might also ask you to do simple tasks like standing on the affected leg to see how your legs are functioning. Sometimes, your doctor will order an X-ray or MRI (magnetic resonance imaging) scan, too, to verify that the pain is due to bursitis and not a fracture or other problem.
Chronic bursitis may involve repeated attacks of pain, swelling, and tenderness. These may lead to the deterioration of muscles and a limited range of motion in the affected joint.
The most common causes of bursitis are repetitive motions or positions that put pressure on the bursae around a joint. Examples include: Throwing a baseball or lifting something over your head repeatedly. Leaning on your elbows for long periods.
Sprains, strains, contusions, tendinitis, bursitis, and synovitis are common soft-tissue injuries. Injury to soft tissues can result in pain, swelling, bruising, and loss of function in the affected area. Often these injuries heal in a week or two, but severe injuries require prompt medical attention.
Hip bursitis
Bursae are small, fluid-filled sacs that cushion the joints and reduce friction between bones. Inflammation of these sacs, known as bursitis, can cause pain and swelling in the hip, which radiates down the leg.
Doctors can often diagnose bursitis based on a medical history and physical exam. Testing, if needed, might include: Imaging tests. X-ray images can't positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort.
The pain is often sharp in the first few days. It may be dull and achy later. You may notice it more when getting out of a chair or bed. You may also notice it when sitting for a long time and when sleeping on the affected side.
It may ease with activity. But left untreated, the pain can become so severe that you're unable to walk.
Septic Hip Bursitis Symptoms
People who have septic hip bursitis may have the symptoms described above and may also notice: Fatigue that does not seem to be related to a lack of sleep. Fever. Sick or fluish feeling (feeling “off”)
Activities or positions that put pressure on the hip bursa, such as lying down, sitting in one position for a long time, or walking distances can irritate the bursa and cause more pain.
Home treatment is often enough to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen the muscles around your joints. Rest the affected area. Avoid any activity or direct pressure that may cause pain.
One of the main causes of hip bursitis is simple wear and tear on the joint. Walking is an example of repetitive motion that can cause bursa to become inflamed.
Routine laboratory blood work is generally not helpful in the diagnosis of noninfectious bursitis. In cases of septic bursitis, however, the leukocyte count and erythrocyte sedimentation rate (ESR) may be mildly to moderately elevated. Blood cultures may be drawn if infection of deep bursae is a concern.
Bursitis is a painful condition that affects the small, fluid-filled pads -- called bursae -- that act as a cushion between the bones and the tendons and muscles near joints. Bursitis is the inflammation of the bursae.
Stretching: Many patients with trochanteric bursitis have a tight IT band. A regular routine of stretching the IT band, along with strengthening exercises for the surrounding hip muscles, usually improves symptoms over the course of just a few weeks.
Disabling joint pain. Sudden inability to move a joint. Excessive swelling, redness, bruising or a rash in the affected area. Sharp or shooting pain, especially when you exercise or exert yourself.
MRI and US can potentially be used to differentiate between gluteus medius tendinitis and trochanteric bursitis in patients with GTPS.
Pain that doesn't go away
Hip bursitis (trochanteric bursitis) may be a sign of a more serious issue. If you continue to have bursitis pain at the hip that has not improved despite extensive treatment, you may have a tear of a muscle located next to the bursa called the gluteus medius.