Iliopsoas Bursitis following Total Hip Replacement Arthroplasty - A Case Report -

Jang Seok Choi; Kyung Chil Chung; Jung Han Kim

doi:10.4055/jkoa.2007.42.3.410

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Choi, Chung, and Kim: Iliopsoas Bursitis following Total Hip Replacement Arthroplasty - A Case Report -

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(3): 410-415.

Published online: 30 June 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.3.410

Iliopsoas Bursitis following Total Hip Replacement Arthroplasty - A Case Report -

Jang Seok Choi, M.D., Kyung Chil Chung, M.D., Jung Han Kim, M.D.

Department of Orthopaedic Surgery, Inje University College of Medicine, Busan, Korea.

Address reprint requests to Kyung Chil Chung, M.D. Department of Orthopaedic Surgery, Inje University College of Medicine, 633-165, Geageum-dong, Busanjin-gu, Busan 614-735, Korea. Tel: +82.51-742-4485, Fax: +82.51-892-6619, drchung@inje.ac.kr

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.

Keywords: Iliopsoas bursitis, Total hip arthroplasty

Figures and Tables

Fig. 1

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

Fig. 2

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

Fig. 3

Probable right hemorrhagic iliopsoas bursitis.

Fig. 4

Heterogeneous hypoechoic lesion in the right inguinal area.

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