Trochanteric Bursitis Treatment London | Private Ultrasound Diagnosis & Injections

Hip Bursitis (Trochanteric Bursitis) Explained

Lateral Hip Anatomy

Trochanteric bursitis describes a condition that causes pain over the outer (lateral) aspect of the hip region.

The bony landmark that can be felt in this area is called the greater trochanter, which is formed where the thighbone (femur) changes direction — from a straight line up from the knee — to angle inward via the femoral neck towards the hip joint in the groin area.

At the greater trochanter bony prominence, the lateral gluteal muscles insert, allowing them to:

• Stabilise the pelvis during walking

• Move the hip into lateral (outward) positions (abduction)

Additionally, the iliotibial band (ITB) runs over the gluteal tendons and greater trochanter in this region, anchoring the lateral thigh to the crest of the pelvis.

Several fluid-filled sacs (bursae) exist in the greater trochanteric region. The most prominent is the trochanteric bursa, which lies at the interface between the lateral gluteal muscles and gluteus maximus muscle. Other bursae in this region include the deep gluteus medius bursa and deep gluteus minimus bursa.

In recent years, the term “greater trochanteric pain syndrome” (GTPS) has become more commonly used, as patients with lateral hip pain often have multifactorial causes, including:

• Inflammation of one or more bursae

• Irregularities of the lateral gluteal tendons

• Thickening or fluid accumulation deep to the iliotibial band in this region

Trochanteric Bursitis Symptoms

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What are the Causes of Trochanteric Bursitis?

Due to the prominence of the greater trochanter and the complex layered anatomy of the region, several key aggravating factors are commonly seen in greater trochanteric pain syndrome.

Symptoms are typically aggravated by:

• Lying on the affected side

• Lying on the opposite side (due to stretch/compression)

• Crossing the legs

• Sitting in low seats (due to compression of the ITB over the painful region)

The gluteal tendons are used to stabilise the pelvis during walking, and during sporting or lateral movements. Therefore, squatting movements and walking may also commonly aggravate symptoms in greater trochanteric pain syndrome.

Trochanteric Bursitis Diagnosis

Diagnostic ultrasound can be considered the imaging modality of choice for cases of lateral hip (trochanteric) pain.

Ultrasound can visualise:

• The gluteal tendons at their insertions

• The bony outline of the greater trochanter

• The bursae and the iliotibial band

Additionally, ultrasound allows dynamic assessment of this region during hip rotation and abduction, which can help identify more subtle causes of pain.

Ultrasound Guided Injections for Trochanteric Bursitis

How is a Trochanteric Bursa Injection Administered?

Depending on the nature of the patient’s symptoms and ultrasound findings, an ultrasound-guided injection can be delivered by placing the ultrasound probe in either a longitudinal or oblique orientation to image the greater trochanter, overlying tendons, and any inflamed bursa.

The needle is visualised as it enters the subcutaneous tissues and advances toward the intended target — usually the irritated bursa — where the injectate can be seen flowing freely into the bursa under real-time ultrasound guidance.

What to Do After Your Trochanteric Bursa Injection

Needle Path & Post-Injection Pain
Although the needle path for a trochanteric bursa injection can be relatively deep, the bursa itself lies on the superficial surface of the tendons and does not require passing through more sensitive musculoskeletal tissues. As a result, the injection is typically straightforward. Some post-injection soreness can occur due to the medication interacting with the bursal fluid and nearby tendons, but this is usually short-lived.

Wound Care & Infection Risk
Avoid exposing the injection site to dirty or public water (e.g., swimming pools, hot tubs) for 2–3 days to reduce infection risk. Monitor for redness, swelling, or discharge at the injection site and contact me if these occur.

Activity Guidance
Avoid aggravating activities such as sitting cross-legged, excessive walking, squats, or other movements that irritate the hip for two weeks following the injection. After two weeks, you can begin an appropriately graded physical therapy program to restore strength and function.

Follow-Up
If you have any concerns or experience unusual pain, redness, swelling, or other issues following your injection, please contact me immediately.

Other Treatments for Trochanteric Bursitis

Stretches for Lateral Hip Pain

Strengthening Exercises for Gluteal Tendinopathy

Advanced  Strengthening Exercises for Gluteal Tendinopathy

Lateral Hip Pain | Evidence base

Modern understanding of greater trochanteric pain syndrome (GTPS) highlights the role of gluteal tendinopathy rather than isolated bursal inflammation. Evidence supports progressive strengthening of the lateral hip musculature, particularly gluteus medius and minimus, as an effective treatment strategy. Several trials show that physiotherapy offers better medium- and long-term outcomes than corticosteroid injection alone, although injections may be useful for acute symptom relief to enable participation in exercise. Surgical interventions, including bursectomy or tendon repair, are rarely required and generally reserved for chronic, resistant cases. Overall, long-term management should focus on restoring tendon function rather than solely reducing inflammation.

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