Clinically. After obtaining a history (talking to the patient about their complaints) and performing a physical exam, the diagnosis of hip bursitis is usually quite obvious. There may be a role for obtaining x-rays to rule out other hip problems, such as arthritis. Mri's may be useful in patients who have failed to improve to look for other problems, eg gluteus medius tears.
Examine the bursa. The hip has a greater and lesser trochanter. Most bursitis pain we see in the hip is around the greater trochanter. The hip bursa is on the ouside of the pelvis. With bursitis there is pain, inflamation and swelling. The bursa is painful to touch, lying on the side, with motion and resistance. Even though swelling is said to occur i rarely see swelling when i ultrasound a painful hip bursa.