Greater Trochanter of Femur

The greater trochanter of the femur is located at the top of the femur bone.   The greater trochanter is evaluated on imaging studies such as X-rays.  It is important for leg movement and overall mobility. In this article we will discuss the greater trochanter’s anatomy, function, and imaging.

Anatomy of the Greater Trochanter

Located at the top of the femur, or thigh bone, the greater trochanter is a bony prominence that you can often feel on the outer side of your hip. It is positioned lateral to the femoral head, which connects the thigh bone to the hip socket, forming the hip joint.

1. Shape and Structure
The greater trochanter has an irregular shape and is easily identifiable on imaging scans due to its prominent protrusion. It is larger than the lesser trochanter, a smaller bony projection situated on the lower inner side of the femur.

2. Muscle Attachment
Several key muscles attach to the greater trochanter:
– *Gluteus Medius and Gluteus Minimus*: These hip muscles are crucial for stabilizing the pelvis and helping lift the leg outward (abduction).
– *Piriformis*: Important in external hip rotation.
– *Obturator Internus and Externus*: Assist with hip movement and stabilization.
– *Gemellus Superior and Inferior*: Smaller muscles aiding in hip rotation.

3. Bursa
A fluid-filled sac known as the trochanteric bursa is positioned over the greater trochanter to reduce friction between the bone and overlying muscles and tendons.

Function of the Greater Trochanter.   Key functions include:

1. **Movement and Mobility**
Its attachment to various muscles ensures proper hip movements, including abduction (lifting the leg away from the body), rotation, and stabilization. It is important for activities such as walking, running, and balancing on one leg.

2. **Joint Stability**
The greater trochanter plays an important role in stabilizing the hip joint, preventing unnecessary movement that could lead to injury.

Imaging and Diagnosis

The greater trochanter is commonly examined in medical imaging when hip pain or injury occurs. Imaging techniques include:

1. **X-Rays**
These scans are often the first step in diagnosing greater trochanter-related issues. They offer detailed views of the bone structure and help detect fractures or deformities.

2. **MRI (Magnetic Resonance Imaging)**
An MRI scan provides a more detailed view of the soft tissues surrounding the greater trochanter. This technique is ideal for identifying muscle or tendon injuries, bursitis, or tears.

3. **Ultrasound**
Ultrasound is increasingly used to evaluate the greater trochanter region. It is particularly useful for identifying bursitis, tendinopathy, and fluid accumulation.

Common Conditions Affecting the Greater Trochanter

Several conditions can cause discomfort or dysfunction in the greater trochanter area, including:

1. **Trochanteric Bursitis**
Inflammation of the trochanteric bursa can result in pain over the greater trochanter, which may extend down the outer thigh. It is often aggravated by prolonged standing or repetitive activities.

2. **Greater Trochanteric Pain Syndrome (GTPS)**
GTPS refers to a collection of conditions affecting the muscles, tendons, and bursae around the greater trochanter. Pain can be sharp or dull, often worsening with physical activity.

3. **Muscle Strains and Tears**
Muscle attachments at the greater trochanter are prone to strains and tears due to overuse or injury. This can cause significant pain and limit hip mobility.

4. **Hip Fractures**
Fractures involving the greater trochanter are more common in older adults due to osteoporosis but can occur in younger people after high-impact trauma. These fractures require immediate medical attention.

Treatment and Rehabilitation

Depending on the diagnosis, treatment may involve a combination of conservative measures and, in some cases, surgery.

1. **Rest and Physical Therapy**
Rest is often essential for healing bursitis and muscle strains. Physical therapy focuses on stretching and strengthening muscles around the greater trochanter.

2. **Medications**
Anti-inflammatory medications can reduce pain and swelling, while corticosteroid injections may be used to relieve severe bursitis.

3. **Surgical Intervention**
For severe cases, especially fractures, surgical intervention might be necessary. This may involve the use of plates, screws, or other implants to stabilize the bone and promote healing.

Conclusion

The greater trochanter of the femur is an important anatomical landmark involved in hip movement, stability, and overall mobility. Imaging is important in diagnosing abnormalities of the greater trochanter.  Understanding its anatomy, function, and common abnormalities is essential for accurate diagnosis and effective treatment.