Presentation
Right hip pain was exaggerated by active flexion for 20 days; there was no history of trauma.
Patient Data
A fluid-filled sac is seen surrounding the right iliopsoas tendon at the level of the hip joint, which displays low T1 and bright STIR/PD fat sat signal intensity along with edematous infiltration of the surrounding soft tissues.
There is no evidence of iliopsoas tendinopathy.
Case Discussion
Clinical presentation and MRI findings are most consistent with iliopsoas bursitis.
Iliopsoas bursa (a.k.a., iliopectineal bursa) is the largest bursa in the human body. It may extend from the pelvis to the lesser trochanter. Communication with the hip joint is seen in up to 15% of cases.
Iliopsoas bursitis is an inflammation of the iliopsoas bursa. It is most often associated with a severe underlying coxopathy (osteoarthritis, rapid destructive osteoarthritis, osteonecrosis of the femoral head, rheumatoid coxitis), but it can be of mechanical origin.