What is the most likely diagnosis for a patient with hip pain after a fall, tenderness over the lateral hip, and intact range of motion?

What is the most likely diagnosis for a patient with hip pain after a fall, tenderness over the lateral hip, and intact range of motion?

• A. Trochanteric bursitis
• B. Lumbar radiculopathy
• C. Iliopsoas tendonitis
• D. Osteoarthritis of the knee

Answer: (A)

Lateral hip pain with focal tenderness over the greater trochanter after a fall, while hip movement remains intact, most likely reflects trochanteric bursitis (greater trochanteric pain syndrome). The greater trochanteric region is the classic site of tenderness in this condition, and inflammation of the bursa or nearby gluteal tendons(S) causes pain that is localized to the outer hip and worsened by activities that load the hip abductors, such as lying on the affected side or with resisted hip movements. Because the range of motion is preserved early, this pattern fits inflammatory or soft-tissue irritation rather than an acute fracture or joint problem. Lumbar radiculopathy would typically present with radicular leg pain, numbness, or weakness in a dermatomal distribution, not isolated lateral hip tenderness with normal hip motion. Iliopsoas tendonitis tends to cause anterior hip or groin pain and tenderness with resisted hip flexion rather than lateral hip tenderness. Osteoarthritis of the knee would produce knee pain and signs of knee joint degeneration, not focal tenderness over the lateral hip. Management is usually conservative: NSAIDs as appropriate, activity modification, and physical therapy focused on hip abductors and core stabilization; corticosteroid injection is considered if symptoms persist despite initial treatment.

Lateral hip pain with focal tenderness over the greater trochanter after a fall, while hip movement remains intact, most likely reflects trochanteric bursitis (greater trochanteric pain syndrome). The greater trochanteric region is the classic site of tenderness in this condition, and inflammation of the bursa or nearby gluteal tendons(S) causes pain that is localized to the outer hip and worsened by activities that load the hip abductors, such as lying on the affected side or with resisted hip movements. Because the range of motion is preserved early, this pattern fits inflammatory or soft-tissue irritation rather than an acute fracture or joint problem.

Lumbar radiculopathy would typically present with radicular leg pain, numbness, or weakness in a dermatomal distribution, not isolated lateral hip tenderness with normal hip motion. Iliopsoas tendonitis tends to cause anterior hip or groin pain and tenderness with resisted hip flexion rather than lateral hip tenderness. Osteoarthritis of the knee would produce knee pain and signs of knee joint degeneration, not focal tenderness over the lateral hip.

Management is usually conservative: NSAIDs as appropriate, activity modification, and physical therapy focused on hip abductors and core stabilization; corticosteroid injection is considered if symptoms persist despite initial treatment.