Bursitis and Tendonitis

Synovial bursae are small fluid-filled sacs that serve as cushioning to decrease friction between bones, muscles, and tendons. Once irritated, the result is an inflammatory condition known as “bursitis.” This often presents with tendonitis which refers to pain, inflammation, or dysfunction of the tendons. Greater trochanteric pain syndrome, previously known as trochanteric bursitis, is defined by lateral hip pain with localized tenderness over the greater trochanter. It is most commonly caused by injury to the tendons of the gluteus medius and gluteus minimus muscles or compression from other adjacent muscles. Iliopsoas bursitis can be referred to as snapping hip syndrome, due to the sensation of snapping or audible snapping noise while the iliopsoas tendon moves across the ilium or anterior hip capsule during activity. Iliopsoas tendonitis often coincides with this bursitis and is known as iliopsoas syndrome. Ischial bursitis refers to the inflammation of the bursa which sits in between the ischial tuberosity and the hamstring tendons which may occur due to leading a sedentary lifestyle or sitting for prolonged periods of time on hard surfaces. Patient history along with physical exam maneuvers are used to diagnose all three forms of bursitis. Imaging using ultrasound, CT, and MRI can provide supporting evidence. Conservative measures along with behavior modifications are standard treatments. In severe cases, corticosteroid injections, platelet-rich plasma injections, or surgical intervention are considered.