The principal trochanteric bursa (also called the subgluteus maximus bursa) lies between the IT band and the posterior-lateral greater trochanter. It is distinct from the gluteus medius bursa (which is deep to the gluteus medius tendon). The principal trochanteric bursa is the bursa most commonly injected with the 'blind' lateral hip injection for GTPS, though ultrasound guidance is more accurate.
Reduces friction between the ITB and the lateral greater trochanter during hip flexion-extension
The principal trochanteric bursa is accessed by ultrasound-guided injection in the supine patient with the hip in neutral rotation, directing the needle from posterior-inferior to the posterolateral trochanteric surface. Distension of this bursa is seen in IT band friction syndrome and GTPS. Its resolution after injection confirms it as a pain contributor.
ITB-trochanter friction bursal inflammation in runners producing lateral hip and thigh pain managed with injection and IT band flexibility work.
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