What is the pathophysiology of bursitis of hip?

Updated: Dec 11, 2020
  • Author: Kristine M Lohr, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Ischiogluteal bursitis is associated with sedentary occupations and is caused by direct stress on the bursa (hence the nickname “weaver’s bottom”). Patients have pain with sitting and walking and have localized tenderness over the ischial tuberosity. Physical examination often reveals pain with passive hip flexion and resisted hip extension.

Iliopsoas bursitis arises when a defect develops in the anterior part of the hip joint capsule, allowing communication of the joint with the bursa. It is often associated with hip pathology (eg, rheumatoid arthritis or osteoarthritis) or recreational injury (eg, running). Infection of the iliopsoas bursa is rare.

Greater trochanter bursitis is common in overweight middle-aged women and is associated with acute trauma, overuse, and mechanical factors. The clinical presentation is of deep, aching lateral hip pain that may radiate into the buttocks or lateral knee. Pain is worse with activity and stretching and may be worse at night, especially when the patient lies on the affected side. Palpation over the greater trochanter elicits severe tenderness. Physical examination reveals pain with resisted hip abduction and external rotation. [14, 15, 16, 17]


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