iliopsoas bursitis—an unusual presentation of ... - Rheumatology

288 BRITISH JOURNAL OF RHEUMATOLOGY VOL. 35 NO. 3
arthritis may have already produced direct communication
between the hip joint and the bursa, therefore
facilitating the rapid increase in the size of the bursa
seen in our patient. The clinical diagnosis was not made
prior to investigation, but ultrasonography quickly
suggested the correct diagnosis, and the MRI scan
demonstrated the communication with an effusion of
the hip and its aetiology.
Although infrequent documentation of isolated
cases suggests a low prevalence, iliopsoas bursitis
may be more common since the recent application of
diagnostic imaging studies has led to increased
awareness of this condition. To most clinicians,
including those specializing in musculoskeletal
disorders, the condition remains unfamiliar and because
its presentation can be so varied it is often not
considered as a cause of symptoms involving the
inguinal area, the lower limb and abdomen. Ultrasound
is the quickest and most cost-effective way
of demonstrating the bursa and its contents, whilst
CT and MRI provide a better appreciation of the
regional anatomy and associated hip joint disease. The
appropriate application of these modalities may
prevent unnecessary investigation and inappropriate
treatment.
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