title: Giant iliopectineal bursitis presenting as neuropathy and severe edema of the lower limb: case illustration and review of the literature.
abstract: We report a 61-year-old woman with rheumatoid arthritis (RA: Steinblocker stage III, class 3) who developed severe swelling and neuropathy of the right lower limb caused by an iliopectineal bursa associated with destruction of the hip joint. Physical examination revealed an inguinal mass and groin pain. X-ray examination indicated destruction of the hip joint. Contrast-enhanced computed tomography showed the bursa connected with the hip joint and a markedly compressed external iliac vein among the inguinal ligament, pubis, and bursa. The patient underwent partial synovial resection and total hip arthroplasty for recovery of hip function, and this led to successful resolution of the symptoms and bursa. We present the characteristic images from this case and review all previously reported cases of RA iliopsoas bursitis causing leg swelling or neuropathy, and summarize the background. Since this lesion may cause various symptoms, clinical awareness that iliopsoas bursitis may present with unique clinical symptoms may aid correct diagnosis.
authors.affiliation: Department of Orthopaedic Surgery, Matsunami General Hospital, Gifu, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Iwata
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nozawa
authors.forename: Minoru
authors.initials: M
authors.lastname: Ohashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakai
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications; D019644:Arthroplasty, Replacement, Hip; D002061:Bursa, Synovial / Q000473:pathology*; D002062:Bursitis / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media / Q000494:pharmacology; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006119:Groin / Q000473:pathology; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D007084:Iliac Vein / Q000473:pathology; D035002:Lower Extremity / Q000473:pathology; D008875:Middle Aged; D011115:Polyneuropathies / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media