A periosteal bursa at the origin of quadratus lumborum on the posterior iliac crest and iliolumbar ligament, reducing friction at the musculotendinous attachment during lateral trunk flexion and forced expiration. It develops in occupations and sports involving repetitive trunk lateral loading.
QL origin bursitis contributes to posterior iliac crest pain that may be confused with iliac crest apophysitis, sacroiliac joint pathology, or lumbar facet disease. It is reproduced by resisted lateral trunk flexion and direct pressure on the posterior iliac crest below the 12th rib. Ultrasound-guided injection at the QL-iliac crest interface confirms the diagnosis. It is often part of a broader QL myofascial pain syndrome treated by dry needling and core strengthening.
Bursal inflammation at the iliac crest QL origin producing posterior iliac crest pain reproduced by lateral trunk flexion, managed with dry needling, stretching, and targeted injection.
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