Distended left iliopsoas bursa - causing acute femoral nerve palsy

Case contributed by Chris O'Donnell
Diagnosis almost certain


Acute left hip pain and weakness of left hip flexors.

Patient Data

Age: 75 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Large fluid filled mass adjacent to the psoas tendon and arising from the joint anteriorly is typical of a distended iliopsoas bursa. Note the displacement of the neurovascular bundle medially especially the vein with the femoral nerve (not identified) sitting lateral to it in direct contact with the fluid collection. 

Ultrasound performed to confirm cystic nature of mass and to allow guided aspiration of the cyst and injcetion of steroid into the cyst

Case Discussion

Distended iliopsoas bursae can present as a mass in the groin. In this case, it appears to have increased in size rapidly (possibly due to hip joint synovitis as it is in continuity with the joint) compressing and distorting the neurovascular bundle, specifically the femoral nerve producing a clinical femoral nerve palsy i.e. weak hip flexors

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