Hip Joint Bursitis & Tendinitis- Causes, Signs, Symptoms, Diagnosis, Treatment
Hip Joint Bursitis
Hip bursitis is inflammation of bursa, which lies between tendon and one of the hip joint bones. Most common hip joint bursitis is ischeal bursitis or trochanteric bursitis.1 Other bursa around hip joint, which may get inflamed are iliopsoas bursa and gluteus medius bursa.
Causes of Hip Joint Bursitis
- Infection 2
Signs and Symptoms of Hip Joint Bursitis
- Pain- While sitting or during activities with movement of hip joint.
- Restricted Hip Joint Movements- Because of pain.
- Intense Pain and Sudden Abrupt Interruption of Movements- When bursa is pressed or squeezed while sitting or during ambulation because of sudden intense pain.
- Diagnostic Signs of Hip Bursitis
- Severe pain during examination of hip joint and site of bursa.
- Signs of rebound pain when hip joint and bursa is palpated.
- Pain while sitting over ischeal tuberosity.
- Investigations for Hip Bursitis
- Ultrasound examination of bursa.
- MRI of soft tissue and bursa.
Treatment For Hip Joint Bursitis
Conservative Treatment of Hip Bursitis
- Exercise- As tolerated.
- Heat- Heated bag is applied over hip joint. Prevent overheating the skin.
- Cold- Ice bag is applied over hip joint, avoid frost bite.
Specific Treatment of Hip Bursitis
- Pain- NSAIDs, avoid opioids if pain is secondary to inflammation.3
- Anti-Inflammatory Medications for Hip Bursitis
- Avoid corticosteroid tablets or injection.
- Antibiotics for Hip Bursitis
- Inflammation not responding to NSAIDs is treated with antibiotics.
- Blood examination and joint fluid study suggests- Infection.
- Physical Therapy for Hip Bursitis
- Initial- As tolerated until inflammation and pain is active.
- Later- Aggressive physical therapy to prevent post inflammatory scarring and stiffness of joint.
Hip Joint Tendinitis
Hip tendinitis is a disease caused by inflammation or injury of the hip joint tendons and ligaments. Hip joint is covered by several ligament and tendon. Tendinitis is often seen following sport injuries, fall, or work injury.
Causes of Hip Joint Tendinitis
- Sport injury- Slip and fall.
- Trauma- Tear of tendon followed by inflammation.
Signs and Symptoms of Hip Joint Tendinitis
- Initial- Mild to moderate pain.
- Later- severe intractable pain.
- Hip Joint Movements:
- At rest- often minimum pain is observed.
- With activities- severe pain is observed with flexion, extension or rotation of hip joint.
- Joint Stability:
- Initial Phase- Joint movements are stable.
- Later Phase- joint movements are unstable and often tendency to fall is observed.
- Abnormal Gait: Gait is often abnormal and limping.
Diagnosis and Investigations for Hip Joint Tendinitis
- Diagnostic Signs Of Hip Tendinitis
- Painful hip joint movements.
- Severe pain is observed when particular movements are involving injured tendon or ligaments.
- Signs of severe pain during palpation and deep pressure over injured tendon.
- Investigations For Hip Tendinitis
- Ultrasound examination of soft tissue and tendon.
- MRI of soft tissue and tendon.
Treatment for Hip Joint Tendinitis
Conservative Treatment for Hip Tendinitis
- Exercise- As tolerated.
- Heat- Heated bag is applied over tender spot. Prevent overheating the skin.
- Cold- Ice bag is applied over hip joint or most painful site, avoid frost bite.
Specific Treatment for Hip Tendinitis
- Opioids- if NSAIDs is ineffective to relieve the pain.
- Antidepressant Analgesics- Treats neuropathic pain and pain not responding to opioids.
- Antiepileptic Analgesics- Treats neuropathic pain and pain not responding to opioids.
- Anti-Inflammatory Treatment For Hip Tendinitis
- Corticosteroids Injection
- Physical Therapy for Hip Tendinitis.
- Interventional Therapy for Hip Tendinitis- Corticosteroid Injection.
- Surgery for Hip Tendinitis- Tendon reconstruction surgery is considered after careful diagnosis using MRI and Ultrasound studies.