Snapshot A 22-year-old college woman presents to her physician with lateral right hip pain. The pain has worsened since she started training for a marathon a few weeks ago. She runs on the same road every morning. On physical exam, there is localized tenderness over the greater trochanter. Pain is elicited with passive external rotation of the right lower extremity. Introduction Clinical definition pain caused by inflammation of the trochanteric bursa Pathogenesis acute trauma or repetitive trauma causes inflammation of the trochanteric bursa Epidemiology Demographics female > male Location bursa superficial to the greater trochanter of the femur Risk factors running on banked surfaces contact sports previous hip surgery falls leg-length discrepancy Presentation Symptoms lateral hip pain that may radiate down the thigh worsens with activity and exercise difficulty sleeping on the affected side no groin pain a true hip disease has referred pain to the groin Physical exam localized tenderness of greater trochanter pain elicited by passive external rotation of the hip Imaging Radiography indication typically not necessary unless the clinical diagnosis is unclear or to rule out a fracture findings within normal limits Magnetic resonance imaging indication typically not necessary unless the clinical diagnosis is unclear or to rule out other pathologies findings increased signal in bursa on T2 sequence Studies Making the diagnosis most cases are clinically diagnosed Differential Sciatica distinguishing factor physical exam usually does not reveal focal tenderness at the trochanteric bursa Treatment Conservative physical therapy indication for all patients rest and ice indication for all patients Medical nonsteroidal anti-inflammatory drugs (NSAIDs) indication pain management injected corticosteroids indication management of pain that is refractory to NSAIDs Complications Persistent pain (greater trochanteric pain syndrome)