IS Case 212: Iliopsoas bursitis
Imaging Sciences URMC 2008
Publication Date: 2009-05-22
Patient is a 53-year-old-male with end stage liver disease.
Left iliopsoas bursitis is incidentally noted on contrast-enhanced CT.
Embryology: From 10 to 20 weeks of development a uterus with fallopian tubes develops from paired tubes called müllerian ducts. The ducts remain unfused cranially to eventually form two separate fallopian tubes. Caudally, they fuse to form the uterus. After fusion, the median septum originally from the fused müllerian ducts resorb and one central cavity of the uterus is created.
Discussion: The iliopsoas bursa is the largest bursa in the body. It is located anterior to the hip joint next to the femoral neurovascular bundle and iliopsoas muscle. The bursa communicates with the hip joint in 15% of individuals. Normally, the bursa is not visualized on imaging. However, the bursa can become distended and cause pain in patients with infection, rheumatoid arthritis, or osteoarthritis. In such cases, CT will demonstrate a fluid collection in the characteristic location. On MRI, iliopsoas bursitis will appear as high signal intensity on T2-weighted sequences and low intensity on T1-weighted sequences. With contrast, the bursal sac enhances, but the contents, do not.
- Kaplan PA, Dussault R, Helms CA, Anderson MW, Majors NM. Musculoskeletal MRI. Philadelphia, PA: Saunders, 2001;349-350.