The iliopsoas bursa extends superiorly from the hip into the iliac fossa between the iliacus and psoas major muscles and the anterior ilium. In its abdominal portion it reduces friction between the fused iliopsoas belly and the iliopectineal eminence of the pelvis during hip flexion. It communicates with the hip joint in approximately 15% of individuals.
An enlarged iliopsoas bursa in its abdominal portion presents as a palpable iliac fossa mass and must be distinguished from an iliac lymph node, iliac artery aneurysm, and appendiceal mass. In rheumatoid arthritis and hip osteoarthritis, the communicating bursa may become massively distended with synovial fluid. CT or MRI identifies the extent of the bursa and any joint communication.
Enlargement of the abdominal iliopsoas bursa from hip joint communication in inflammatory arthropathy, presenting as an anterior hip or iliac fossa mass with groin pain on hip flexion.
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