Which symptom is more characteristic of trochanteric bursitis than a hip fracture?

• A. Shortened leg with external rotation
• B. Swelling of the knee
• C. Pain when lying on the affected side
• D. Deformity of the hip

Answer: (C)

Pain when lying on the affected side reflects irritation of the bursa over the greater trochanter, which is a hallmark of trochanteric bursitis. Lying on the involved hip compresses the inflamed bursa and reproduces the local lateral hip pain, a pattern not typical of a fracture. In contrast, a hip fracture usually causes severe constant hip or groin pain with inability to bear weight, and physical exam often shows a shortened leg with external rotation and sometimes deformity. Knee swelling isn’t linked to a primary hip issue, and deformity of the hip is more characteristic of fracture. So, pain when lying on the affected side best distinguishes trochanteric bursitis from a hip fracture.