MRI Iliopsoas Bursitis
Iliopsoas bursitis, also known as iliopectineal bursitis, is an inflammatory condition involving the iliopsoas bursa, a fluid-filled sac located in the pelvic region. This bursa acts as a cushion, reducing friction between the iliopsoas muscle and the pelvis or hip bone. Inflammation of this bursa can lead to pain and discomfort, often associated with hip and groin region.
Causes:
Overuse or Repetitive Stress: Common in athletes, especially runners, or individuals involved in activities requiring repetitive hip flexion.
Hip Injury or Trauma: Direct injury to the hip area can lead to inflammation of the bursa.
Arthritis: Conditions like rheumatoid arthritis or osteoarthritis can precipitate iliopsoas bursitis.
Leg Length Discrepancy: Uneven leg lengths can cause abnormal gait, leading to extra stress on the bursa.
Symptoms:
Pain: Often the most prominent symptom, typically felt in the front of the hip, but it can also radiate to the thigh, groin, or lower back.
Swelling: May occur in the affected area.
Tenderness: The area over the bursa may be tender to touch.
Stiffness: The hip might feel stiff, especially after prolonged sitting or in the morning.
Reduced Range of Motion: Movement of the hip, particularly hip flexion, may become limited.
Treatment:
Rest: Reducing activities that exacerbate the symptoms is crucial.
Ice Therapy: Applying ice to the affected area can help reduce inflammation and pain.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen can help in reducing pain and inflammation.
Physical Therapy: Guided exercises to strengthen the surrounding muscles, improve flexibility, and correct any biomechanical issues.
Corticosteroid Injections: These can be administered into the bursa to reduce inflammation and pain, though their use may be limited due to potential side effects.
Surgery: In rare cases where conservative treatments fail, surgical intervention to remove the inflamed bursa may be considered.
MRI Appearance of Iliopsoas Bursitis
T1-Weighted Images:
- In T1-weighted images, fluid within the bursa, which is indicative of bursitis, typically appears as low signal intensity (dark) compared to surrounding structures.
- The iliopsoas muscle and tendon appear as intermediate to low signal intensity.
T2-Weighted Images:
- On T2-weighted images, fluid within the bursa appears as high signal intensity (brighter), which is indicative of inflammation or fluid accumulation.
- These images are particularly useful for detecting edema and inflammation.
STIR (Short Tau Inversion Recovery):
- STIR is a fluid-sensitive sequence that suppresses fat signal, making fluid appear very bright. This is very sensitive for detecting edema or inflammation.
- Iliopsoas bursitis will show as increased signal intensity (brighter areas) in the region of the bursa.
PD (Proton Density) Fat Saturation:
- This sequence also helps in detecting fluid and edema. The fat saturation component suppresses the signal from fat, making it easier to view edema or fluid.
- The inflamed bursa would appear as an area of increased signal intensity (brightness) compared to the surrounding structure
T2 TSE sagittal image shows Iliopsoas Bursitis
![T2 TSE sagittal image shows Iliopsoas Bursitis](/wp-content/uploads/2023/11/T2-TSE-sagittal-image-shows-Iliopsoas-Bursitis-1024x601.jpg)
STIR coronal image shows Iliopsoas Bursitis
![STIR coronal image shows Iliopsoas Bursitis](/wp-content/uploads/2023/11/STIR-coronal-image-shows-Iliopsoas-Bursitis-1024x601.jpg)
T1 coronal image shows Iliopsoas Bursitis
![T1 coronal image shows Iliopsoas Bursitis](/wp-content/uploads/2023/11/T1-coronal-image-shows-Iliopsoas-Bursitis-1024x601.jpg)
STIR axial image shows Iliopsoas Bursitis
![STIR axial image shows Iliopsoas Bursitis](/wp-content/uploads/2023/11/STIR-axial-image-shows-Iliopsoas-Bursitis-1024x601.jpg)
T1 axial image shows Iliopsoas Bursitis
![T1 axial image shows Iliopsoas Bursitis](/wp-content/uploads/2023/11/T1-axial-image-shows-Iliopsoas-Bursitis-1024x601.jpg)
References
- Skiadas, V., Koutoulidis, V., & Plotas, A. (2009). An atypical case of noninfected iliopsoas bursitis – MRI findings. J Radiol Case Rep, 3(10), 15–18. doi:10.3941/jrcr.v3i10.326
- Corvino, A., Venetucci, P., Caruso, M., Tarulli, F. R., Carpiniello, M., Pane, F., Sabatino, V., Franzese, R., Catalano, O., Corvino, F., & Catelli, A. (2020). Iliopsoas bursitis: The role of diagnostic imaging in detection, differential diagnosis, and treatment. Radiology Case Reports, 15(11), 2149-2152.
- Varma, D. G. K., Richli, W. R., Charnsangavej, C., Samuels, B. I., Kim, E. E., & Wallace, S. (1991). MR Appearance of the Distended Iliopsoas Bursa. AJR, 156(5), 1025-1028. doi:10.2214/ajr.156.5.201025
- Wunderbaldinger, P., Bremer, C., Schellenberger, E., Cejna, M., Turetschek, K., & Kainberger, F. (2002). Imaging features of iliopsoas bursitis. European Radiology, 12(2002), 409-415.