The occasional injection for trochanteric bursitis.

Screening questions will usually sort out the location and source of the pain: “Is it sore when you are lying in bed?”; “Is it sore when you lie on that side?” Trochanteric bursitis occurs about 4 inches lateral to the hip joint and hurts when the patient lies on it. Soreness occurs with climbing ladders or hills, running or using elliptical trainers. In distinction to osteoarthritis of the hip, trochanteric bursitis does not cause much soreness with walking. Also, osteoarthritis of the hip is not generally painful with lying in bed. Confirm with the patient that no pathological flags are present (e.g., history of cancer, night pain, constant pain). Sometimes there is an obvious precipitant (e.g., the patient went camping with the kids and slept on a rock, was doing a lot of uphill hiking or training, or sleeps on a poor mattress). Often the pain is longstanding and increasingly bothersome. It is more common in wom en (4:1) and affects between 15% and 20% of the population.