Hip Ultrasound: Diagnosing Bursitis & Tendonitis

If you have persistent hip pain that gets worse with movement, your hip joint could be affected by inflammation – and there are a lot of potential causes. Skip the long NHS wasting lists and get a private ultrasound for hip pain to find out what’s causing your pain and symptoms.

Here, we’ll explore common causes of hip joint pain and how a hip ultrasound examination can help you get an accurate diagnosis.

Understanding hip pain and common conditions

Anatomy of your hip joint

Your hip joints are the largest ball-and-socket joints in your body. The ‘ball’ part is the top of your thigh bone (femoral head). The ‘socket’ is formed by the side of your pelvis.

To make the socket deeper and more secure, there’s a thick ring of cartilage called the labrum, which lines the rim of the socket. There’s also cartilage lining some of the inner surface of the socket and the femoral head of your thigh bone – this is called articular cartilage.

Your hip joint also contains many fluid-filled sacs. These are called bursae and sit between the bony surfaces of the joint and the surrounding tissues. They help to reduce friction when the joint moves.

In addition to bones, bursae and cartilage, your hip joint contains ligaments, tendons, blood vessels and nerves. Any of these tissues can be damaged and cause hip pain and discomfort.

Main causes of hip pain: bursitis, tendonitis, and other hip disorders

Two common causes of persistent hip pain are trochanteric bursitis and hip tendonitis. Other causes include strains and sprains to tendons, ligaments and muscles, as well as bone damage.

Trochanteric bursitis

Trochanteric bursitis refers to inflammation of the trochanteric bursa that sits on part of the outer thigh bone called the greater trochanter.

When the trochanteric bursa becomes irritated or inflamed, it can cause pain along the outer part of your hip, along the upper side of your thigh and in your buttocks. Pain is usually worse when moving, getting up from sitting or lying on the affected hip.

Trochanteric bursitis is usually caused by repetitive hip motion, eg when cycling or running, or due to an impact to the hip.

Hip tendonitis

Hip tendonitis refers to inflammation of one of the tendons in the hip. One of the most commonly affected tendons is the iliopsoas tendon that connects the iliopsoas muscle to the thigh bone. It supports hip flexion, so you can bring your knee up to your chest.

As with trochanteric bursitis, this tendon can become inflamed due to a direct impact or repetitive hip motion when exercising, especially if you suddenly increase the intensity of your exercise. It causes hip pain along the front of your hip and groin area, which gets worse when moving.

Over time, untreated tendonitis can lead to tendonopathy, ie degeneration of the tendon and tearing of such tendons in severe cases.

Other common causes of hip pain

Sudden, severe hip pain is usually caused by trauma, such as an impact, which can damage soft tissues and/or cause a hip fracture or hip dislocation.

Hip pain that comes on gradually is usually caused by overuse and wear and tear. This includes bursitis and tendonitis, as well as hip arthritis, specifically osteoarthritis, and repetitive strain injuries to muscles.

Labral tears – ie tears to the labrum of the hip socket – can be caused by both overuse and trauma.

Hip effusions (fluid build-up within the joint) can also contribute to stiffness and reduced range of movement.

Hip ultrasound: what is it and how does it work?

How ultrasound detects the source of hip pain

A diagnostic ultrasound scan of your hip can help identify the underlying causes of hip pain as ultrasound imaging creates live images of your soft tissues.

Your ultrasound practitioner will use a handheld ultrasound probe attached to a computer. The probe releases high frequency sound waves into your hip. These sound waves bounce back whenever they encounter areas of different densities.

The reflected sound waves are picked up by the probe and converted into grayscale pictures. Over 1,000 sound waves bounce back every second, allowing real time imaging of your hip joint.

Comparing ultrasound with MRI for hip diagnosis

You don’t need to do any special preparation for an ultrasound or MRI scan of the hip. However, you may be asked to change into a hospital gown. It’s a good idea to wear comfortable, loose fitting clothing that’s easy to change out of.

Unlike MRI, you don’t need to stay still for an ultrasound. A diagnostic ultrasound allows you to move your joint during scanning if needed, so your ultrasound practitioner can see how your joint responds to movement. This is called a dynamic assessment.

The ultrasound machine is a portable device with a handheld probe, so you won’t need to lie down in an enclosed space to have your scan, as you would with MRI.

Ultrasound is also more cost-effective than MRI and doesn’t use powerful magnets. That means individuals with metal implants that aren’t compatible with MRI can still have an ultrasound scan as an alternative imaging modality.

Unlike CT and X rays, ultrasound doesn’t use radiation, so it’s safe to have repeated ultrasound scans.

However, ultrasound only produces 2D images, while MRI produces 3D images. MRI also produces much more detailed images compared to ultrasound, which can help detect more subtle signs of disease or damage.

After your hip ultrasound

You can return to your usual activities straight after your hip ultrasound. When you choose Vista Health for your scan, we aim to deliver a report with your scan results within 3 working days.

Your report will be overseen by an experienced Vista Health Consultant Radiologist or ultrasound practitioner and can be sent to your NHS GP for follow-up. Alternatively, you can book a private GP consultation with Vista Health that suits your schedule.

One of our highly skilled GPs will explain what your results mean for you, including any next steps, such as further tests or treatment to reduce pain and restore range of motion.

Treatment may include medication, manual therapy, physiotherapy, ultrasound guided injections of steroids, or, in more serious cases, surgery.

Get your hip health back on track

Is hip pain stopping you from getting on with your day? Get to the bottom of it with a private ultrasound scan of your hip with Vista Health. Simply self-refer to book your scan and have your hip symptoms investigated now.