Trochanteric Bursitis or Hip Abductor Tear?

    I recently had a patient with a history of being diagnosed with "trochanteric bursitis." While her therapy at the time was not for the hip, the patient often complained of pain superoposterior to the greater trochanter. This pain could be reproduced with ambulation and palpation. Having learned of bursitis being misdiagnosed before, I decided to delve into the topic. Upon further discussion, I learned she had the hip pain for approximately 5 years following being diagnosed with bursitis. The patient reported that no MRI was ordered for her hip. She also presented with a positive uncompensated trendelenburg during gait, pain with active hip abduction, pain-free passive hip abduction. Upon review of the literature, it appears there could potentially be a large incidence of hip abductor tears being missed in these patients. This article discusses how the findings of patients with hip abductor tears are shown to be similar to the signs of those diagnosed with bursitis. With the load our hip musculature withstands throughout a lifetime and the potential excessive load due to compensating for other gait deviations, perhaps we should be taking a second look at our elderly patients with hip pain that do not seem to be progressing.