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Giant iliopectineal bursitis presenting as neuropathy and severe edema of the lower limb: case illustration and review of the literature

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Abstract

We report a 61-year-old woman with rheumatoid arthritis (RA: Steinblocker stage III, class 3) who developed severe swelling and neuropathy of the right lower limb caused by an iliopectineal bursa associated with destruction of the hip joint. Physical examination revealed an inguinal mass and groin pain. X-ray examination indicated destruction of the hip joint. Contrast-enhanced computed tomography showed the bursa connected with the hip joint and a markedly compressed external iliac vein among the inguinal ligament, pubis, and bursa. The patient underwent partial synovial resection and total hip arthroplasty for recovery of hip function, and this led to successful resolution of the symptoms and bursa. We present the characteristic images from this case and review all previously reported cases of RA iliopsoas bursitis causing leg swelling or neuropathy, and summarize the background. Since this lesion may cause various symptoms, clinical awareness that iliopsoas bursitis may present with unique clinical symptoms may aid correct diagnosis.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Matsunami General Hospital, Gifu, Japan

    Takahiro Iwata

  2. Sanford-Burnham Medical Research Institute, 10901 North Torrey Pines Road, La Jolla, CA, 92037, USA

    Satoshi Nozawa

  3. Department of Orthopaedic Surgery, Ibi Kosei Hospital, Gifu, Japan

    Minoru Ohashi & Hiroshi Sakai

  4. Department of Orthopaedic Surgery, Gifu University School of Medicine, Gifu, Japan

    Satoshi Nozawa & Katsuji Shimizu

Authors
  1. Takahiro Iwata
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  2. Satoshi Nozawa
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  3. Minoru Ohashi
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  4. Hiroshi Sakai
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  5. Katsuji Shimizu
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Correspondence to Satoshi Nozawa.

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Iwata, T., Nozawa, S., Ohashi, M. et al. Giant iliopectineal bursitis presenting as neuropathy and severe edema of the lower limb: case illustration and review of the literature. Clin Rheumatol 32, 721–725 (2013). https://doi.org/10.1007/s10067-013-2223-5

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  • DOI: https://doi.org/10.1007/s10067-013-2223-5

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