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What causes mild asymmetric trochanteric bursal effusion as per the MRI?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10285 Questions
I have had left hip pain for 15 years, I have done physical therapy, repeated cortisone shots, ice, etc. I am done with it all. Nothing is working. My rheumatologist will do no more cortisone and sent me for an MRI and referral to an ortho. Xrays show calcification near the bursa on my left hip. The MRI indicates: mild asymmetric trochanteric bursal effusion which contains 16x11x9 mm calcification. Soft tissue swelling. This calcification may be associated with the anteriormost fibers of the insertional gluteus medius along the lateral greater trochanter facet. the gluteus minimus is intact.

Impression is: 16 mm calcification associated with ventral insertional gluteus medius tendon of the left hip with mild associated trochanteric bursitis and surrounds soft tissue edema. Findings may represent hydroxyapatite deposition disease of the gluteus medius insertion. Also trochanteric enthesopathy.

What does all this mean in layman terms. This has been miserable and continually wakes me up at night for the past several years. What surgical intervention can be done. I am ready.
Posted Tue, 21 Nov 2017 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 2 hours later
Brief Answer:
Platelet rich plasma can help.

Detailed Answer:
Thanks for posting your query.
The findings of the MRI scan indicate an inflammation of the bursa of the hip joint and chronic inflammation in the area has caused a calcification which also involves a tendon. This can be due to deposition of hydroxyapetite also. Enthesopathy is characterized by pathologic, sometimes painful changes at the insertion sites (entheses) of tendons, ligaments, and articular capsules into bone.
Severe cases of hip enthesopathy, such as the greater trochanteric bursal pain, can be successfully treated with platelet-rich plasma injections. Surgery is not very helpful in these cases. Do discuss this option with your orthopedician.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL
Above answer was peer-reviewed by
Follow-up: What causes mild asymmetric trochanteric bursal effusion as per the MRI? 6 minutes later
My insurance will not pay for plasma injections. My friend had to pay $3000 for one in her knee. I am not independently wealthy. What other options? I can’t take this any longer!
Answered by Dr. Praveen Tayal 10 hours later
Brief Answer:
Steroid shots can help.

Detailed Answer:
Thanks for writing again.
The other options are pain killers steroid shots and TENS therapy and regular physiotherapy. But all these will provide a temporary relief.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
Follow-up: What causes mild asymmetric trochanteric bursal effusion as per the MRI? 5 hours later
Ok this is my final question. I have done everything you listed. For 15 years I might add. I feel my only option is to have a bursectomy and have the Calification cleaned out. They can do this via Hip arthoscopy. I have had so many cortisone shots over the 15 year period. My doctors don't want to do them any longer. People that have done the bursal removal's and are happy. Isn't this an option?
Answered by Dr. Praveen Tayal 7 hours later
Brief Answer:
Surgery can have a variable result.

Detailed Answer:
Surgery is an option but it is not successful in all the cases. Some inflammation and pain might be persistent even after the surgery. It all depends on the expertise of the surgeon and the strength of tendons and ligaments that need to be decalcified.
Above answer was peer-reviewed by
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