Greater TrochanterEdit

The greater trochanter is a prominent bony projection on the proximal femur, serving as a key anatomical landmark for the hip joint. Located laterally, it marks the point where several important hip muscles attach and where the upper leg lever meets the pelvis. The structure is central to how the hip stabilizes the body during movement and bears load during walking, running, and single-leg stance. In clinical practice, the greater trochanter is often referenced in discussions of hip pain, fractures, and various soft-tissue conditions around the hip.

Anatomy and relationships

The greater trochanter sits at the junction of the femoral neck and shaft and is bordered by surfaces that accommodate muscle attachments. The major tendinous insertions from the hip abductors—the gluteus medius and gluteus minimus—attach to the lateral aspect of the greater trochanter, where their tendons spread to brace the pelvis during stance. The tendon of the piriformis muscle runs near the superior border of the greater trochanter, contributing to external rotation of the hip. The region also contains a complex network of bursae, most notably the trochanteric bursa, which lies between the greater trochanter and overlying soft tissues to reduce friction during hip movement.

Morphology of the greater trochanter can vary among individuals, with minor differences in the size, projection, and shape of the bony prominence. These variations can influence the relative leverage of the attached tendons and the susceptibility of the surrounding soft tissues to irritation or injury. For imaging and surgical planning, the greater trochanter serves as an important reference point in procedures involving the hip and femur. See also femur and hip for broader context about the bones and joints involved.

Function

As part of the proximal femur, the greater trochanter provides insertion sites for the main hip abductor muscles, which stabilize the pelvis during gait and help initiate leg lifting away from the body. The gluteus medius and gluteus minimus muscles, anchored at the greater trochanter, generate abduction and contribute to the medial–lateral balance required for smooth walking. The region also participates in external rotation and aids in distributing forces transmitted through the hip during locomotion. Because of these roles, pathology involving the greater trochanter often manifests as lateral hip pain and functional weakness in the affected leg.

Clinical significance

The greater trochanter is central to several common clinical problems of the hip region:

Trochanteric pain syndrome, a spectrum that includes irritation or inflammation around the greater trochanter and surrounding soft tissues, often presenting as lateral hip pain that worsens with activity. See trochanteric pain syndrome for a broader discussion of the condition.
Greater trochanteric bursitis, an inflammatory condition of the trochanteric bursa that can cause localized tenderness and pain with lying on the affected side or during hip movement. See bursitis for a general overview of bursae-related pain.
Abductor tendon pathology, including tears or tendinopathy of the gluteus medius and minimus as they attach to the greater trochanter, which can lead to a Trendelenburg gait pattern and functional instability.
Fractures of the greater trochanter, typically seen in older adults with osteoporosis or in high-energy trauma. Such fractures may threaten hip stability and require careful assessment and treatment planning. See hip fracture for related fracture concepts.
Imaging findings, including radiographs, ultrasound, and magnetic resonance imaging (MRI), are used to evaluate bony integrity and soft-tissue structures in the trochanteric region. See MRI and ultrasound for discussions of contemporary imaging modalities.

Imaging and diagnosis

Diagnosing trochanteric and adjacent hip pathology involves correlating clinical presentation with imaging findings. Plain radiographs can identify fractures or deformities, while MRI provides detailed information about soft-tissue structures such as the gluteal tendons and the trochanteric bursa. Ultrasound can be a practical, dynamic tool to assess bursitis or tendon pathology in real time. Clinicians weigh these imaging results against symptoms, physical examination (for example, assessment of hip abductor strength and gait), and patient history to establish an accurate diagnosis. See radiography and MRI for related imaging topics.

Treatment and management

Management of greater trochanter–related conditions emphasizes a tiered approach:

Conservative care, including activity modification, targeted physical therapy to strengthen the hip abductors, and nonsteroidal anti-inflammatory medications, is a first-line strategy for many patients with trochanteric pain or bursitis.
Injections, such as ultrasound-guided corticosteroid injections into the trochanteric bursa, can provide symptom relief for localized inflammation.
For persistent or recalcitrant cases, surgical options may be considered. These can include endoscopic procedures to address bursal irritation or repair of abductor tendon pathology associated with the greater trochanter. See endoscopic bursectomy and gluteus medius/gluteus minimus repair for related surgical concepts. In some instances, treatment may extend to broader hip joint interventions such as hip replacement when degenerative disease is present.

The discussion around the best course of action reflects a balance between evidence-based, cost-effective care and patient-specific factors such as activity level, occupation, and comorbidities.

Controversies and debates

As with many musculoskeletal topics, there are ongoing debates about diagnosis, management, and terminology:

Imaging versus clinical diagnosis: a tension exists between relying on imaging findings and prioritizing a patient’s clinical symptoms and functional impairment. Some clinicians argue imaging can reveal incidental findings that do not explain pain, while others advocate for imaging to guide targeted treatments.
Conservative versus surgical management: in abductor tendon pathology and chronic trochanteric pain, there is disagreement about how quickly to proceed with surgery. Advocates of early intervention argue for faster restoration of function in select patients, while proponents of conservative care emphasize nonoperative approaches and the risks and costs of surgery.
Terminology and naming conventions: there is an ongoing discussion in medicine about the balance between descriptive terminology and eponym-based naming. Some argue that eponyms are outdated and can obscure meaning, while others value traditional terms for historical continuity and clinical familiarity.
Woke criticisms and medical discourse: some observers argue that broader cultural critiques should influence medical education and practice, including how conditions are described or prioritized in research and training. From a traditional, evidence-focused standpoint, proponents contend that patient care should be anchored in demonstrable outcomes and cost-effectiveness, and that debates framed around social constructs should not derail attention from core clinical questions. Critics of dismissive positions argue that acknowledging social determinants and equity can improve access and outcomes; proponents of a more restrained approach argue that resources are best allocated toward interventions with proven clinical benefit.