The trochanteric bursa (subgluteus maximus or principal trochanteric bursa) is the largest bursa at the greater trochanter, lying deep to the gluteus maximus and iliotibial tract and superficial to the gluteus medius insertion and the posterolateral greater trochanter. It is distinguished from the smaller subgluteus medius and minimus bursae by its more superficial position and larger size. It is the bursa most commonly injected for greater trochanteric pain syndrome.
| Location | Lateral to the greater trochanter, deep to the gluteus maximus and iliotibial tract, over the gluteus medius insertion and posterior facet |
|---|---|
| Nearby |
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Reduces friction between the gluteus maximus and iliotibial tract and the greater trochanter during hip movement
Greater trochanteric pain syndrome (GTPS, formerly called trochanteric bursitis) produces lateral hip pain reproduced by palpation of the greater trochanter and by resisted hip abduction. The pain pattern extends to the lateral thigh and is worse lying on the affected side. Gluteus medius and minimus tendinopathy is the primary driver in most cases, with bursitis secondary to tendon degeneration. Ultrasound-guided corticosteroid injection into the bursa is more accurate than blind injection and provides diagnostic confirmation and relief. External snapping hip (coxa saltans externa), from the thickened posterior iliotibial band or anterior edge of gluteus maximus flicking over the trochanter, can irritate this bursa and is confirmed on dynamic ultrasound. PRP injection and surgical gluteal tendon repair or iliotibial band release address refractory cases.
Lateral hip pain from gluteus medius tendinopathy with secondary trochanteric bursitis, worsening with side-lying and single-leg activities, managed with load modification and gluteal strengthening.
The iliotibial band or anterior gluteus maximus edge snaps over the greater trochanter during hip flexion and extension, producing a visible lateral snap and bursal irritation, managed with stretching and injection, and surgical lengthening of the band in refractory cases.
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