The iliopsoas bursa (also called the iliopectineal bursa) is the largest bursa around the hip, lying between the iliopsoas tendon and the anterior hip capsule and iliopectineal eminence. It communicates with the hip joint in approximately 15 percent of normal adults and more often in hip pathology, so a hip effusion can extend into the bursa and produce an anterior hip or groin mass; a markedly distended bursa can extend upward into the iliac fossa. Snapping hip syndrome from the iliopsoas tendon snapping over the iliopectineal eminence is closely related to this bursa.
| Location | Between the iliopsoas tendon and the anterior hip joint capsule and iliopectineal eminence |
|---|---|
| Nearby |
|
Reduces friction between the iliopsoas tendon and the anterior hip joint capsule during hip flexion
Iliopsoas bursitis presents as deep anterior groin pain, often reproduced by passive hip extension, or as an anterior hip mass, and imaging is required to identify whether the bursal fluid communicates with the hip joint. A communicating bursa in a patient with hip pain implies a joint effusion that requires investigation for its cause, and in rheumatoid arthritis or osteoarthritis the bursa can become massively distended. A large bursa extending into the iliac fossa must be distinguished from iliac lymphadenopathy, an iliac artery aneurysm, and other pelvic masses with ultrasound, CT or MRI. Internal snapping hip (coxa saltans interna) from the iliopsoas tendon snapping over the iliopectineal eminence or femoral head produces a palpable and audible anterior snap, confirmed on dynamic ultrasound. It is managed with stretching and strengthening, ultrasound-guided injection, and rarely arthroscopic iliopsoas tendon release.
Anterior groin swelling and pain from bursal inflammation, often communicating with a hip joint effusion that requires investigation for its underlying cause.
Marked enlargement of a communicating bursa in rheumatoid arthritis or hip osteoarthritis, presenting as an anterior hip or iliac fossa mass with groin pain on hip flexion.
Audible snap at the anterior hip from the iliopsoas tendon snapping over the iliopectineal eminence during hip flexion and extension, managed with stretching, injection of the tendon-bursa complex, and rarely arthroscopic tendon release.
