Which physical findings are characteristic of iliopsoas bursitis?

Updated: Dec 11, 2020
  • Author: Kristine M Lohr, MD, MS; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Pain from iliopsoas bursitis radiates down the anteromedial side of the thigh to the knee and is increased on extension, adduction, and internal rotation of the hip. Typically, the pain worsens slowly over weeks or months; it may be the only symptom present. Tenderness may occur anteriorly below the middle of the inguinal ligament and lateral to the femoral artery. Occasionally, a palpable mass or visible edema may be found lateral to the femoral vessels. Pulsations from the femoral artery are sometimes transmitted through this mass.

Retroperitoneal extension can cause an abdominal or pelvic mass that gives rise to compressive syndromes in the groin (eg, femoral vein compression or femoral neuropathy) or pelvis (eg, medial displacement of pelvic structures or superior displacement of abdominal structures). A classic triad of a palpable mass, extrinsic pressure on adjacent structures, and radiographic changes of advanced arthritis was described, but this triad has been determined not to be sensitive for early disease. Diagnostic imaging may assist with diagnosis.


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