Presentation
Acute left hip pain and weakness of left hip flexors.
Patient Data
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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 neuromuscular bundle, specifically the femoral nerve producing a clinical femoral nerve palsy i.e. weak hip flexors
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