Trochanteric bursitis is defined by the inflammation of the bursa located near the greater trochanter of the femur, the bony point on the outside of the hip. This inflammation commonly results in discomfort localized to the outer hip and upper thigh. Many people experiencing this hip issue also report pain that travels farther down the leg, manifesting as discomfort in the knee. The anatomical structures connecting the hip and the knee joint mean that a problem originating at the hip can indeed manifest as pain around the knee. Examining the path of the tissues that bridge these two major joints helps explain this connection.
The Anatomical Link to Knee Discomfort
The connection between trochanteric bursitis and knee discomfort is channeled primarily through the iliotibial (IT) band. This thick, fibrous strip of fascia originates near the hip, spans the outer thigh, and inserts just below the knee joint. The greater trochanter, where the inflamed bursa is located, is a point where the IT band passes over the bone.
Inflammation in the trochanteric bursa can lead to friction and increased tension on the overlying IT band. This mechanical irritation at the hip causes the entire length of the band to become tight or restricted. Since the IT band crosses the lateral side of the knee, this increased tension translates into referred pain or direct irritation around the knee joint.
The discomfort felt in the knee is not typically an injury to the knee joint itself, but a sensation transmitted along the stressed anatomical structure. Pain from the hip often radiates down the lateral aspect of the thigh and is perceived near the outer knee. This tightness can also lead to iliotibial band syndrome, characterized by friction as the band slides over the bony prominence on the outer knee. This dual mechanism explains why a problem beginning at the hip produces knee-level symptoms, generally localized to the outside (lateral) portion of the knee, corresponding to the IT band’s path.
Identifying the Primary Source of Pain
Differentiating between knee discomfort caused by trochanteric bursitis and a true primary knee condition involves carefully examining the location and triggers of the pain. Pain originating from the inflamed bursa is characteristically felt on the lateral hip, often described as a sharp pain that may evolve into a dull ache. This discomfort is frequently aggravated by activities that put pressure directly on the hip, such as lying on the affected side while sleeping.
The pain is also commonly triggered when standing up after prolonged sitting or when climbing stairs due to the muscles pulling across the inflamed bursa. The pain from bursitis rarely extends below the knee. Conversely, true knee joint pathology, such as a meniscal tear or arthritis, often presents with pain directly along the knee’s joint line, sometimes accompanied by mechanical symptoms like clicking, locking, or instability.
Primary knee issues are often directly linked to movements that stress the joint, such as twisting, pivoting, or deep squatting. If the primary point of tenderness is the hip, and the knee pain is only on the outer side, it points strongly toward a hip-related referred issue, whereas genuine knee problems involve tenderness localized to structures within the knee itself.
Medical Evaluation and Diagnosis
A medical professional confirms the source of the pain through a comprehensive physical examination and targeted tests. The examination typically involves palpation, where the physician presses directly on the greater trochanter to check for point tenderness, a classic finding in trochanteric bursitis. They also assess for tightness in the IT band and may attempt to reproduce the lateral hip pain by performing specific movements, such as resisted hip abduction.
Imaging studies are often utilized to distinguish the source of the symptoms and rule out other possibilities. X-rays may be ordered to ensure that bone issues, like arthritis in the hip joint or bone spurs, are not contributing to the discomfort. If the diagnosis remains uncertain or if the knee joint integrity needs to be evaluated, an ultrasound or magnetic resonance imaging (MRI) scan can provide a clearer picture of the soft tissues.
These advanced imaging techniques confirm the presence of an inflamed bursa at the hip or assess for concurrent issues like iliotibial band syndrome or a primary knee injury. Accurate identification of the pain source is necessary because the diagnosis dictates the appropriate treatment pathway: bursitis may be treated with anti-inflammatory medications or steroid injections, while primary knee issues often require specific physical therapy or other interventions.