A 32-year-old woman presents with gradual onset pain localized to the lateral aspect of the hip. She is afebrile, with tenderness over the greater trochanter when the patient lies on the unaffected side in the lateral decubitus position. What is the most likely diagnosis?

• A. Meralgia paresthetica
• B. Iliotibial band syndrome
• C. Trochanteric bursitis
• D. Gluteal strain

Answer: (C)

Lateral hip pain with tenderness directly over the greater trochanter, especially when lying on the affected side, points to inflammation of the bursa over that area. This is trochanteric bursitis. The trochanteric bursa sits between the greater trochanter and the overlying gluteal tendons/IT band, and repetitive friction or overuse can inflame it, causing focal tenderness at the trochanter and pain with weight bearing or side-lying on the affected side.

Meralgia paresthetica would produce numbness or burning on the outer thigh without focal tenderness over the greater trochanter. IT band syndrome can cause lateral hip or knee pain but typically presents with tenderness along the band itself and is more activity-related. A gluteal strain is usually an acute muscle injury with pain and weakness on resisted hip movements, not isolated trochanteric tenderness.