J Korean Orthop Assoc.  2007 Jun;42(3):410-415. 10.4055/jkoa.2007.42.3.410.

Iliopsoas Bursitis following Total Hip Replacement Arthroplasty: A Case Report

• Choi JS
• Chung KC
• Kim JH

• KMID: 2186569
• DOI: http://doi.org/10.4055/jkoa.2007.42.3.410

Abstract

PURPOSE: To report the clinical, radiological and surgical findings of iliopsoas bursitis, and to suggest an indication for diagnosis and treatment.
MATERIALS AND METHODS
We report two patients with iliopsoas bursitis who underwent THA in between June 1998 to June 2003. All presented with late onset hip joint discomfort, and their diagnosis were confirmed after interdepartmental consultations and with the help of investigations such as interventional angiography and MRI. Their signs, symptoms, investigations and surgical findings were reviewed retrospectively.
RESULTS
Iliopsoas bursitis presented with hip pain, leg edema, palpable inguinal mass and ecchymosis, femoral nerve irritation and flexion contracture of hip. The radiographs provided no diagnostic clues but the MRI revealed a well marginated cystic lesion filled with fluid signals. Ultrasonography revealed the anatomic location that enabled guided aspiration and even ruled out vascular compromise. Two patients were treated with USG guided aspiration. One aspirate was serosanguinous and the other was old blood tinged fluid. One patient underwent surgical debridement of the cyst. Surgery revealed an intrapelvic hemorrhagic bursa with an ill-defined cystic wall and intramuscular extension into the iliacus.
CONCLUSION
It is important for surgeons to rule out iliopsoas bursitis when a patient presents with vague hip pain after total hip arthroplasty without any evidence of infection or loosening. A diagnosis of iliopsoas bursitis can be made from the clinical features and ultrasonography.

Keyword

Iliopsoas bursitis; Total hip arthroplasty

MeSH Terms

Angiography
Arthroplasty*
Arthroplasty, Replacement, Hip*
Bursitis*
Contracture
Debridement
Diagnosis
Ecchymosis
Edema
Femoral Nerve
Hip
Hip Joint
Humans
Leg
Magnetic Resonance Imaging
Referral and Consultation
Retrospective Studies
Tolnaftate
Ultrasonography
Tolnaftate

Figure

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  Fig. 1 A short segmental luminal narrowing at the EIV-CFV junction is evident.

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  Fig. 2 Probable left iliopsoas bursitis, causing compression of left common femoral vein.

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  Fig. 3 Probable right hemorrhagic iliopsoas bursitis.

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  Fig. 4 Heterogeneous hypoechoic lesion in the right inguinal area.

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