As the iliopsoas tendon descends from the iliopectineal eminence toward the lesser trochanter, a small bursa develops between the tendon and the anterior hip capsule or femoral neck at the greater trochanter level. It is distinct from the main iliopsoas bursa at the pelvic brim and from the deep trochanteric bursae.
Iliopsoas bursitis at this level contributes to anterior hip pain during hip flexion and may mimic hip joint pathology. Ultrasound-guided injection targeting the iliopsoas tendon at the level of the femoral neck or lesser trochanter distinguishes this bursa from the deeper hip joint. In total hip arthroplasty, iliopsoas impingement from an overhanging acetabular cup produces pain at this level managed by psoas release or cup revision.
Bursal and tendon irritation at the iliopsoas lesser trochanter insertion producing anterior hip pain with resisted hip flexion, a recognised complication of acetabular cup overhang in total hip arthroplasty.
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