Tuberculous bursitis of the greater trochanter

A patient with tuberculous bursitis of the greater trochanter is reported. A 37-year-old woman had experienced persistent dull hip pain and noticed diffuse swelling over the greater trochanteric region. Plain radiograph revealed unremarkable osteopenic changes in the greater trochanter and faint mineralization in the vicinity of the trochanter. Computed tomogram showed erosion of the trochanter and a large soft tissue mass. Magnetic resonance imaging demonstrated a large multicystic mass. Histology of the cyst wall, showing chronic granulomatous tissue, and a positive culture of Mycobacterium tuberculosis confirmed the diagnosis of musculoskeletal tuberculosis. Complete excision of the lesion, followed by 6 months of antituberculous chemotherapy with rifampicin and isoniazid, cured the disease. There has been no sign of recurrent disease in 30 months of follow-up. Correct diagnosis was difficult because of its rarity, but modern imaging technology, magnetic resonance imaging, in particular, was extremely useful for showing the extent of the disease. Tuberculous infection should be considered as a differential diagnosis in patients with persistent hip pain. Received for publication on July 11, 1997; accepted on Nov. 6, 1997