Skeletal Radiology

, Volume 14, Issue 2, pp 85–94 | Cite as

Synovial cysts of the hip joint and iliopsoas bursitis: A spectrum of imaging abnormalities

  • David J. Sartoris
  • Larry Danzig
  • Louis Gilula
  • Guerdon Greenway
  • Donald Resnick


Synovium-related soft tissue disease around the hip constitutes a spectrum ranging from isolated iliopsoas bursitis to pure articular synovial herniations without bursal involvement. The clinical, pathologic, and radiographic features of these entities are discussed as they pertain to the variety of underlying disorders which predispose to their occurrence. Nine case reports are utilized to illustrate the variable clinical and radiographic presentations which may be encountered. Based upon these cases as well as those in the literature, an imaging algorithm has been developed which should eliminate unnecessary studies and allow prompt and accurate diagnosis.

Key words

Synovial membrane, cysts Synovial membrane Bursa Bursitis Hip, arthritis Hip, radiography Hip, arthrography Hip, abnormalities 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Armstrong P, Saxton H (1972) Ilio-psoas bursa. Br J Radiol 45:493Google Scholar
  2. 2.
    Baker WM (1885) Formation of abnormal synovial cysts in connection with joints. St. Bartholomew Hosp Rep 21:177Google Scholar
  3. 3.
    Bywaters EGL (1965) The bursae of the body. Ann Rheum Dis 24:215Google Scholar
  4. 4.
    Carr CR, Berley FV, Davis WS (1954) Pigmented villonodular synovitis of hip joint: case report. J Bone Joint Surg [Am] 36:1007Google Scholar
  5. 5.
    Carrera GF, Papadakes N, Imray TJ (1980) Retropsoas extension of ruptured hip capsule: arthrographic demonstration. AJR 135:1293Google Scholar
  6. 6.
    Case TC (1958) Synovial cyst of the right hip joint. NY State J Med 58:4079Google Scholar
  7. 7.
    Chaiamnuay P, Davis P (1984) An unusual case of inguinal swelling. Arthritis Rheum 27:239Google Scholar
  8. 8.
    Chandler SB (1934) The iliopsoas bursa in man. Anat Rec 58:235Google Scholar
  9. 9.
    Cook TK (1952) Ganglion of the hip: case report. Surgery 32:129Google Scholar
  10. 10.
    Coventry MB, Polley HF, Weiner AD (1959) Rheumatoid synovial cyst of the hip. J Bone Joint Surg [Am] 41:721Google Scholar
  11. 11.
    Cullen TS (1910) A large cystic tumor developing from the iliopsoas bursa containing large free cartilagenous masses and communicating with the hip joint. JAMA 54:1181Google Scholar
  12. 12.
    Dahlin DC (1957) Bone tumors: general aspects and an analysis of 2,276 cases. Charles C. Thomas, Springfield, p 264Google Scholar
  13. 13.
    Eisenberg KS, Johnston JO (1972) Synovial chondromatosis of the hip joint presenting as an intrapelvic mass. A case report. J Bone Joint Surg [Am] 54:176Google Scholar
  14. 14.
    Finder JG (1938) Iliopectineal bursitis. Arch Surg 36:519Google Scholar
  15. 15.
    Freiberger R, Kaye J (1979) Arthrography. Appleton-Century-Crofts, New York, p 192Google Scholar
  16. 16.
    Freund E (1940) The pathological significance of intra-articular pressure.Edinburgh Med J 47:192Google Scholar
  17. 17.
    Fricke JI (1834) Ueber die Bursa mucosa iliaca und deren Communickation mit dem Hueftgelenke. J Chirurgie Augen-Heilkunde 21:223Google Scholar
  18. 18.
    Gardner DL (1978) Pathology of rheumatoid arthritis. In: Copeman's textbook of the rheumatic diseases. 5th edn. Churchill Livingstone, Edinburgh, p 273Google Scholar
  19. 19.
    Gatch WD, Green WT (1925) Cysts of the ilio-psoas bursa. Ann Surg 82:277Google Scholar
  20. 20.
    Gerber NJ, Dixon ASJ (1974) Synovial cysts and juxta-articular bone cysts (geodes). Semin Arthritis Rheum 3:323Google Scholar
  21. 21.
    Goldberg RP, Weissman BN, Naimarck A, Braunstein E (1983) Femoral neck erosions: sign of hip joint synovial disease. AJR 141:107Google Scholar
  22. 22.
    Herrington JL, Edwards LW (1955) Ganglion cysts arising in unusual locations. Ann Surg 142:900Google Scholar
  23. 23.
    Hucherson DC, Denman FR (1946) Non-infectious iliopectineal bursitis. Am J Surg 72:576Google Scholar
  24. 24.
    Hucherson DC, Freeman GE Jr (1962) Iliopectineal bursitis. A cause of hip pain frequently unrecognized. Am J Orthop 4:220Google Scholar
  25. 25.
    Jacobs P, Goei The HS, Bijlsma A, Versteege CW (1983) Rheumatoid synovial cyst of the hip. Arthritis Rheum 26:814Google Scholar
  26. 26.
    Janus CL, Hermann G (1982) Enlargement of the iliopsoas bursa: unusual cause of cystic mass on pelvic sonogram. J Clin Ultrasound 10:133Google Scholar
  27. 27.
    Jayson MIV (1968) Study of a valvular mechanism, in the formation of synovial cysts. Ann Phys Med 9:243Google Scholar
  28. 28.
    Jayson MIV, Dixon ASJ (1970) Valvular mechanisms in juxta-articular cysts. Ann Rheum Dis 29:415Google Scholar
  29. 29.
    Johnson EW Jr, Granberry WM (1962) Ganglion cyst of the hip: report of three cases. Am J Othop 4:216Google Scholar
  30. 30.
    Keller C, Leden I, Lidgren L, Stenberg T (1980) Anaerobic bacterial coxitis and pseudocystic tumor in rheumatoid arthritis. Scand J Rheumatol 9:216Google Scholar
  31. 31.
    Kessel F (1927) Über die Bursa mucosa iliopectinea, ihre Entwicklung und ihre Kommunikation mit der Kapsel des Hüftgelenkes. Morphol Jahrb 58:413Google Scholar
  32. 32.
    Kolmert L, Persson BM, Herrlin K, Ekelund L (1984) Ileopectineal bursitis following total hip replacement. Acta Orthop Scand 55:63Google Scholar
  33. 33.
    Kummer E, deSenarclens P (1917) Un cas d'hygroma chronique de la bourse du psoas-iliaque ou iliopectinee. Rev Med Suisse Romande 37:574Google Scholar
  34. 34.
    Lehner A (1924) Zur Schleimbeutel- und Gelenksosteochondromatose. Schweiz Med Wochenschr 18:634Google Scholar
  35. 35.
    Levy RN, Hermann G, Haimov M, Sherry HS, Train JS, Davison S (1982) Rheumatoid synovial cyst of the hip. Arthritis Rheum 25:1382Google Scholar
  36. 36.
    Lund FB (1902) The iliopsoas bursa. Boston Med Surg J 147:345Google Scholar
  37. 37.
    Margreiter R, Steiner E, Mikuz C (1978) Das Ganglion des Hüftgelenkes. Chirurg 49:620Google Scholar
  38. 38.
    McBeath AA, Neidhart DA (1976) Acetabular cyst with communicating ganglion. A case report. J Bone Joint Surg [Am] 58:267Google Scholar
  39. 39.
    Melamed M, Bauer CA, Johnson JH (1967) Iliopsoas bursal extension of arthritic disease of the hip. Radiology 89:54Google Scholar
  40. 40.
    Menninger W (1932) Über Entzündung der Bursa iliopectinea. Dtsch Z Chir 237:775Google Scholar
  41. 41.
    O'Conner DS (1933) Early recognition of iliopectineal bursitis. Surg Gynecol Obstet 57:674Google Scholar
  42. 42.
    Penkava RR (1980) Iliopsoas bursitis demonstrated by computed tomography. AJR 135:175Google Scholar
  43. 43.
    Peters JC, Coleman BG, Turner ML, Arger PH, Mulhern CB Jr, Dalinka MK, Allan DA, Schumacher HR (1980) CT evaluation of enlarged iliopsoas bursa. AJR 135:392Google Scholar
  44. 44.
    Resnick D, Niwayama G (1981) Diagnosis of bone and joint disorders with emphasis on articular abnormalities. Saunders, Philadelphia, p 880, 1015, 1019, 1156, 1495, 1500, 2103Google Scholar
  45. 45.
    Samuelson C, Ward JR, Albo D (1971) Rheumatoid synovial cyst of the hip. A case report. Arthritis Rheum 14:105Google Scholar
  46. 46.
    Staple TW (1972) Arthrographic demonstration of iliopsoas bursa extension of the hip joint. Radiology 102:515Google Scholar
  47. 47.
    Stephens VR (1944) Cystic tumor of iliopectineal bursa. Report of two cases. Arch Surg 49:9Google Scholar
  48. 48.
    Sumanovac Z (1959), Traumatic cyst in the hip joint. J Bone Joint Surg [Am] 41:175Google Scholar
  49. 49.
    Takahiko T, Hirofumi C, Moto K (1978) Rheumatoid synovial cyst of the hip joint. Clin Orthop 137:191Google Scholar
  50. 50.
    Torisu T, Chosa H, Kitano M (1978) Rheumatoid synovial cyst of the hip joint. A case report. Clin Orthop 137:191Google Scholar
  51. 51.
    Warren R, Kaye JJ, Salvati EA (1975) Arthrographic demonstration of an enlarged iliopsoas bursa complicating osteoarthritis of the hip. J Bone Joint Surg [Am] 57:413Google Scholar
  52. 52.
    Watson JD, Ochsner SF (1967) Compression of bladder due to “rheumatoid” cysts of hip joint. AJR 99:695Google Scholar
  53. 53.
    Weisser JR, Robinson DW (1951) Pigmented villonodular synovitis of iliopectineal bursa: case report. J Bone Joint Surg [Am] 33:988Google Scholar
  54. 54.
    Witter JA, Swingle NE (1957) Ilioinguinal swellings. Am J Surg 94:653Google Scholar

Copyright information

© International Skeletal Society 1985

Authors and Affiliations

  • David J. Sartoris
    • 1
  • Larry Danzig
    • 2
    • 3
  • Louis Gilula
    • 4
  • Guerdon Greenway
    • 5
  • Donald Resnick
    • 1
  1. 1.Department of Diagnostic RadiologyVeterans Administration Medical CenterUSA
  2. 2.Department of OrthopedicSurgeryVeterans Administration Medical CenterUSA
  3. 3.University of California HospitalSan DiegoUSA
  4. 4.Mallinckrodt Institute of RadiologySt. LouisUSA
  5. 5.Department of RadiologyBaylor University Medical CenterDallasUSA
  6. 6.Department of RadiologyVeterans Administration, Medical CenterSan DiegoUSA

Personalised recommendations