The infragluteal bursa lies at the inferior border of the gluteus maximus at the gluteal fold, between the inferior edge of the muscle and the underlying hamstring tendons at the ischial tuberosity. It reduces friction between the large gluteus maximus and the underlying hamstring origins as the hip flexes and the gluteus maximus tenses over the ischial region. It is distinct from the ischiogluteal bursa which lies directly between the ischial tuberosity and overlying skin.
The infragluteal bursa may become inflamed in conditions causing prolonged hip flexion loading, or from direct compressive trauma to the gluteal fold. Pain in this region can be confused with proximal hamstring tendinopathy, ischiogluteal bursitis, or deep gluteal syndrome from sciatic nerve irritation. Clinical distinction requires careful palpation to identify the maximal tenderness point relative to the ischial tuberosity and the gluteal fold. Ultrasound-guided injection into the infragluteal bursa is both diagnostic and therapeutic.
Inflammation of the infragluteal bursa from repetitive hip flexion loading produces deep gluteal fold pain reproduced by hip flexion and direct palpation at the inferior gluteus maximus margin, managed with activity modification and corticosteroid injection.
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