What is Hip Bursitis

What is Hip Bursitis Blog  Hip Bursitis

Small containers of fluid are located throughout the body and are known collectively as bursae and individually as a bursa. Functioning much like a pillow or cushion, these containers of fluid are strategically located in the joints and around the ends of important bones like the elbow, knee, heel, and shoulder. Using the medical suffix “itis” to indicate that the tissue has become irritated, hip bursitis is the condition in which the bursae of the upper leg bone which makes contact with the hip are damaged and become tender and irritated.

How Hip Bursitis Injuries Occur

Most cases of hip bursitis are the result of long-term damage to the underlying bursae. As the bursae become damaged from overuse, they can start to become irritated and tender. Some cases of hip bursitis occur after receiving a direct injury to the hip from violent interactions with an object, person, or the ground. Other cases of hip bursitis are the secondary effect of developing bone spurs, arthritis, or a curved spine.

Most sports injuries involving hip bursitis are inflicted on the bursae in the side of the hip due to violent strikes to the exterior of the hip and/or top of the leg. This type of injury is called trochanteric bursitis. Hip bursitis in non-athletes is usually to back side of the hip and is referred to as ischial bursitis.

Who Is Vulnerable to a Hip Bursitis Injury

Sports medicine experts have revealed that the most common type of activity associated with developing hip bursitis is training for marathons as overuse and pressure on the hip joint can result in irritation and inflammation of the bursae. Other vigorous activities with an increased risk of developing a hip bursitis injury include contact sports like hockey, rugby, lacrosse, and American football where players sometimes get a hard object crashing against the outside of the hip.

A number of secondary conditions can lead to an increased risk of developing hip bursitis. These may include:

  • People with a case of gout or what’s known as pseudo-gout.
  • People who stress or push their hips too far.
  • Individuals with another form of hip injury.
  • Damaged immune systems, especially people with a staph infection.
  • Anyone who has diabetes mellitus.
  • People whose legs are not of the same length.
  • Anyone with bone spurs on their hips.
  • People with posture problems, especially individuals with conditions like scoliosis.

Symptoms of a Hip Bursitis Injury

Hip bursitis is usually diagnosed on the spot by laypersons and can be identified through a number of symptoms, including:

  • Aching or tenderness in the hip.
  • Warmth felt in the affected area.
  • Sharp discomfort in the upper leg that fades to a dull aching pain after a while.
  • Tightness and lack of flexibility in the hip.
  • Discomfort that starts at the outside of the hip and then shoots down to the upper leg.
  • Increased discomfort when moving up stairs, squatting, dancing, or walking for a long time.
  • Developing a limp and/or feeling a loss of power in the leg muscles.

Hip bursitis is called acute if the symptoms appear for just a few hours or days. Hip bursitis is called chronic if it lasts for a really long time or continues to disappear and then re-appear.

Treating a Hip Bursitis Injury

Most of the time, cases of hip bursitis are self-diagnosed based on the known checklist of symptoms associated with this type of injury. In more severe cases, trained medical personnel may perform an MRI or X-ray scan in order to accurately diagnose the ailment.

Anyone with a case of hip bursitis is counseled to rest for a couple of days to allow the injury to begin to heal. The standard course of therapy is to apply cold to the site, as long as it is on the outside of the clothes, to the area for 5-15 minutes, repeated two to four times a day. To minimize tenderness and discomfort, people with hip bursitis can take an aspirin or ibuprofen. If the tenderness or discomfort remains severe, crutches can be used to help make walking less uncomfortable.

Once the discomfort has been reduced, the standard course of treatment for hip bursitis is a number of flexibility and strength-building movements.

For more egregious cases of hip bursitis, it may be necessary for a doctor to remove excess fluid from the injured bursa and/or inject the injured area with a drug to minimize tenderness and discomfort. Surgical intervention is only rarely appropriate and then only for the most severe cases of hip bursitis.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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