Iliopsoas Bursitis: Difference between revisions
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== Search Strategy == | == Search Strategy == | ||
Databases: Pubmed<br>Keywords: Iliopsoas bursitis, bursitis, physiotherapy<br> | Databases: Pubmed<br>Keywords: Iliopsoas bursitis, bursitis, physiotherapy, groin pain, physical therapy<br> | ||
== Definition/Description == | == Definition/Description == |
Revision as of 12:35, 5 January 2014
Original Editors - Andrea Nees
Top Contributors - Audrey De Bry, Simisola Ajeyalemi, Andrea Nees, Kim Jackson, Admin, Leana Louw, Uchechukwu Chukwuemeka, Laura Danhieux, WikiSysop and Lucinda hampton
Search Strategy[edit | edit source]
Databases: Pubmed
Keywords: Iliopsoas bursitis, bursitis, physiotherapy, groin pain, physical therapy
Definition/Description[edit | edit source]
For the definition of bursitis: See Bursitis
This kind of bursitis is one of the affections related to anterior hip pain.
Clinically Relevant Anatomy[edit | edit source]
The iliopsaos bursa is the largest bursa of the human body and is bilaterally present in 98% of adults. This bursa is bounded by the musculotendinous junction of the M. iliopsoas (anteriorly) and by the fibrous capsule of the hip (posteriorly). It extends from the inguinal ligament superiorly to the lesser trochanter inferiorly and is flanked by the femoral vessels (medially) and the femoral nerve (laterally). [2]
Epidemiology /Etiology[edit | edit source]
Iliopsoas bursitis is mainly caused by:
- Rheumatoid arthritis
- Acute trauma
- Overuse injury
Iliopsoas bursitis is commonly seen in individuals participating in:
- Strength training
- Rowing
- Uphill running
- Competitive track and field
This kind of bursitis mainly affects young adults. It occurs slightly more often in women than men. [3](Level of evidence: A1)
Characteristics/Clinical Presentation[edit | edit source]
- Pain is generally felt in the groin, anterior part of the thigh, knee and leg
- Pain develops during walking or specific movements like crossing the legs
- Pain is increased when acting weight-bearing activities, putting on socks and shoes, or rising from a chair. [4]
- The pain is worse by hip movements and relieved by rest. [3]
Differential Diagnosis[edit | edit source]
Distension can be caused by several joint diseases:
- Osteoarthritis
- Rheumatoid arthritis
- Avascular necrosis
- Pigmente villonodular synovitis
- Synovial chondromatosis
- Gout
- Chondrocalcinosis
- Trauma
- Lupus erythematodes
- Pyogenic infection
[2]
Differential diagnosis of anterior hip pain by anatomical structure:
- Joint
o Osteoarthritis
o Inflammatory synovitis
o Loose bodies
o Infection (septic joint)
o Crystal-induced synovitis (gout)
o Labral tears
- Bone
o Femur
Stress fracture
Avascular necrosis of femoral head
Bone tumour
Infection
o Pelvis
Hip fracture
Stress fracture
Osteitis pubis
- Muscle, endon, bursa
o Iliopsoas bursitis and tendinitis
o Iliopsoas strain
o Retus femoris strain
o Tight iliotibial band
- Vasculature
o Aneurysm
o Arteriovenous malformation
- Pelvic mass
o Gastrointestinal causes (e.g. hernia)
o Genitourinary causes (e.g. ureteral stone)
- Nerve
o Obturator nerve entrapment
o Myalgia paraesthetica
o Referred from lumbar spine (L1, L2)
Diagnostic Procedures[edit | edit source]
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Outcome Measures[edit | edit source]
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Examination[edit | edit source]
- Tenderness to palpation can be found distal to the midpoint of the inguinal ligament in the femoral triangle
- There is a limitation in ROM according to a NIET-CAPSULAIR patron
- Exorotation is painful and has a soft EINDGEVOEL
- Flexion is lightly painful at the end of ROM
- Sometimes pain can be felt at the end of ROM when extension or adduction UITGEVOERD WORDT.
- The most painful movement is adduction with the hip in flexion.
- There’s no weakness of muscles.
- A palpable and/or audible snap can be present [3](level of evidence: A1)
[4]
Medical Management
[edit | edit source]
The patient can take anti-inflammatory medications. There could be performed aspiration and corticosteroid injections of the bursa for persistent pain symptoms. [1]
If physical therapy is unsuccessful, a corticosteroid injection could be the next line of intervention.Surgery is rarely. [3]
Physical Therapy Management
[edit | edit source]
The treatment includes stretching of the hip flexor muscles. After that a strengthening program (for hip rotators) can be followed.
Stretching exercises (involving hip extension) performed for 6 to 8 weeks alleviate the symptoms. [3] (Level of evidence: A1)
See more exercises on Therapy exercises for the hip
Key Research[edit | edit source]
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Resources
[edit | edit source]
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Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
1. Parziale J.R., O’Donnell C.J , Sandman D.N., Iliopsoas Bursitis, Am. J. Phys.Med. Rehabil. Vol 88, No.8, August 2009
2. Van de Perre S., Vanwambeke K., Vanhoenacker F.M., De Schepper A.M., Posttraumatic iliopsoas bursitis, JBR-BTR, 2005, 88:154-155
3. Johnston C.A.M., Wiley J.P., Lindsay D.M., Wisemand D.A., Iliopsoas bursitis and tendinitis (a review), Sports Med, april 1998; 25 (4): 271 – 283 (Level of evidence: A1)
4. Ombregt L., Bisschop P., ter Veer H.J., Van de Velde T., A System of Orthopaedic Medicine. 1999.