CT evaluation of enlarged lliopsoas bursa

Musculoskeletal pitfalls and pseudotumours in the pelvis: a pictorial review for body imagers

Many musculoskeletal abnormalities in the pelvis are first seen by body imagers while reviewing pelvic cross-sectional studies, and some of these abnormalities may mimic malignancy or another aggressive process. This article describes nine musculoskeletal pseudotumours and interpretative pitfalls that may be seen on CT, MRI and ultrasound imaging of the pelvis. Awareness of these pitfalls and pseudotumours may help avoid misdiagnosis and prevent inappropriate intervention or management.

[Femoral superficial vein thrombosis due to a large iliopsoas bursitis secondary to polyethylene wear debris in total hip arthroplasty]

A 76 year old male patient with a history of implantation of a total hip arthroplasty Perfecta (Orthomet(®)), who presented with an iliac fossa mass, increased diameter of the thigh, and pain during hip flexion and extension. CT and ultrasound show the presence of a giant cystic mass in left iliac fossa about 7 cm in diameter next to the prosthesis. A pseudo-tumour secondary to wear debris after placement of a total arthroplasty is rare. We present a case of a large iliopsoas bursitis caused by polyethylene particles, which caused compression and thrombosis of the superficial femoral vein.

Distended iliopsoas bursa: case reports and anatomical dissection

Distension of the iliopsoas bursa is usually seen in association with underlying hip joint disease. The computed tomography (CT) appearance is characteristic and allows a diagnosis to be readily made. Computed tomography will also facilitate needle placement for aspiration of bursa contents and the injection of water-soluble contrast media for CT bursography. Three cases of iliopsoas bursa enlargement of varying underlying aetiology are presented. The dissection of seven cadavers demonstrated the anatomy of the normal bursa and highlighted its important role in the normal functioning of the iliopsoas muscle.

Ilio-psoas bursa enlargement

The clinical and radiological features of 14 patients with ilio-psoas bursal enlargement associated with articular disease of the hip are presented. The condition primarily affects patients over the range of 50 years with pre-existing hip disease, usually of long duration. A clinical diagnosis before investigation was never made in our series as the symptoms were non-specific and varied, consisting of pain (40%), a palpable groin mass (40%) and lower limb swelling (28%). The diagnosis can be made pre-operatively and the extent along the path of the ilio-psoas accurately delineated. The bursal contents, although predominantly fluid in nature, do include a varying proportion of solid components. Ultrasound is the simplest, quickest and most cost effective means of demonstrating the hip effusion, the bursa, its contents and extent. Although the compressive effects are well seen sonographically, computed tomography (CT) and magnetic resonance imaging (MRI) provide a better appreciation of the regional anatomy and hip joint disease.

Infective iliopsoas bursitis. A case report

We report a case of infective iliopsoas bursitis, and to our knowledge a similar case has not been described. The anatomical relation between the bursa and the hip, and related pathological conditions are reviewed. The contribution of CT-guided catheterisation is emphasised as it allows aspiration of fluid, injection of radio-opaque material and lavage.

Iliopsoas bursitis: clinical features, radiographic findings, and disease associations

Inflammation of the iliopsoas bursa is a common manifestation of a wide array of inflammatory, degenerative, and traumatic musculoskeletal conditions. The clinical presentation of iliopsoas bursitis is variable, and includes pain, mass lesion, or compression syndromes of the inguinal compartment. Affected individuals frequently have underlying synovitis of the hip or a history of occupational or recreational injury. Early and accurate diagnosis is facilitated by appropriate radiographic studies.

The magnetic resonance imaging appearance at 1.5 tesla of cartilaginous tumors involving the epiphysis

Three cases of lytic, calcified epiphyseal lesions with plain film and computed tomography features suggestive of chondroblastoma were imaged by magnetic resonance imaging. Histopathologic correlation was obtained in each case. Two cases of chondroblastoma showed low signal intensity on both short (TR600/TE20ms) and long (TR2500/TE80ms) spin echo (SE) images. The third case, a clear cell chondrosarcoma, demonstrated increased signal intensity on moderately T2 weighted (TR2500/TE40ms) images. These findings suggest that magnetic resonance imaging may be helpful in distinguishing these lesions.

Synovial cysts of the hip joint and iliopsoas bursitis: a spectrum of imaging abnormalities

Synovium-related soft tissue disease around the hip constitutes a spectrum ranging from isolated iliopsoas bursitis to pure articular synovial herniations without bursal involvement. The clinical, pathologic, and radiographic features of these entities are discussed as they pertain to the variety of underlying disorders which predispose to their occurrence. Nine case reports are utilized to illustrate the variable clinical and radiographic presentations which may be encountered. Based upon these cases as well as those in the literature, an imaging algorithm has been developed which should eliminate unnecessary studies and allow prompt and accurate diagnosis.