A bursa between the erector spinae aponeurosis and the posterior iliac crest where the aponeurosis attaches, reducing friction during trunk movement where the aponeurosis slides over the iliac crest surface. It may develop in athletes and manual workers with repetitive trunk loading.
Erector spinae aponeurosis bursitis produces posterior iliac crest tenderness at the aponeurotic attachment, a location easily confused with superior cluneal nerve entrapment. Palpation over the posterior iliac crest just lateral to the midline identifies this bursa. Ultrasound-guided injection targets the aponeurotic-iliac interface. Thoracolumbar fascia pathology and erector spinae aponeurosis bursitis frequently coexist in chronic lower back pain.
Bursal inflammation at the erector spinae aponeurosis-iliac crest junction producing posterior iliac crest pain reproduced by direct pressure and trunk flexion, managed with targeted injection and core rehabilitation.
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