Hip Bursitis: Ultrasound-Guided Injection and Complete Recovery
Published on 2026-05-21
Trochanteric Bursitis: A Common and Treatable Lateral Hip Pain
Trochanteric bursitis (or greater trochanteric pain syndrome) is one of the most common causes of pain on the side of the hip. It predominantly affects women aged 40 to 60, but can occur at any age, particularly in athletes and active individuals.
What is Hip Bursitis?
The trochanteric bursa is a small sac filled with synovial fluid located between the greater trochanter (the bony prominence on the outside of the hip) and the surrounding gluteal muscles. Its role is to reduce friction between bone and soft tissues. When it becomes inflamed, this is called trochanteric bursitis.
Causes are multiple:
- Excessive friction (running, cycling, prolonged walking)
- Muscle imbalance (weakness of the gluteal muscles)
- Biomechanical abnormalities (leg length discrepancy)
- Associated hip pathologies (arthritis, gluteal tendinitis)
- Prolonged lying on the painful side
Symptoms
- Pain on the outer side of the hip, sometimes radiating down the thigh
- Pain when lying on the affected side (night pain)
- Tenderness to palpation over the greater trochanter
- Pain when climbing stairs or during prolonged sitting
- Pain during resisted hip abduction
Ultrasound Diagnosis
Musculoskeletal ultrasound is the key examination. It directly visualizes the thickened and/or fluid-filled trochanteric bursa, and allows exclusion of differential diagnoses (gluteal tendinitis, hip arthritis, gluteus medius tendinopathy).
Ultrasound-Guided Injection
The ultrasound-guided injection is the gold standard treatment for trochanteric bursitis. Using real-time ultrasound imaging, the physician precisely guides a fine needle into the inflamed bursa. A small dose of corticosteroid (cortisone) is then injected directly into the bursal sac. This targeted approach ensures maximum efficacy while minimizing risks. The procedure takes only a few minutes and provides rapid pain relief, often within 24 to 48 hours. Most patients experience significant improvement after a single injection, although some may require a second procedure. Combining the injection with a tailored physiotherapy program addressing muscle imbalances is essential for long-term results and prevention of recurrence.
Frequently Asked Questions
Can hip bursitis heal on its own?
In mild cases, rest and avoiding triggering positions may suffice. However, most patients require an injection for rapid and lasting relief, especially if pain disturbs sleep or daily activities.
Why is ultrasound-guided injection recommended for hip bursitis?
The trochanteric bursa is a deep structure located beneath several muscle layers. Without ultrasound guidance, the risk of missing the target is high (accuracy rate < 50% with blind injection). Ultrasound guidance ensures that cortisone is injected exactly into the inflamed bursa.
How many physiotherapy sessions are needed after the injection?
A program of 6 to 12 sessions over 6 to 8 weeks is generally sufficient to correct muscle imbalances and prevent recurrence. The key is perseverance with home exercises.
Which sports should be avoided with trochanteric bursitis?
Sports with lateral impact or repetitive abduction movements (running, football, tennis, horseback riding) can aggravate bursitis. Swimming, stationary cycling, and Nordic walking are generally well tolerated.