Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review

Background: Bursitis iliopectinea (BI) is a condition that is characterized by swelling of the iliopsoas bursa, leading to compression of inguinal neurovascular structures, causing swelling, pain, paresthesia, or thrombosis of the leg. Questions: Due to the rare occurrence of BI, the available liter...

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Main Authors: Malgorzata Lea Jonczy, Lorenz Büchler, Yadusha Mahenthiran, Fabrice Helfenstein, Christian Apenzeller-Herzog, Andrej Isaak
Format: Article
Language:English
Published: SAGE Publishing 2025-02-01
Series:SAGE Open Medicine
Online Access:https://doi.org/10.1177/20503121251317899
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author Malgorzata Lea Jonczy
Lorenz Büchler
Yadusha Mahenthiran
Fabrice Helfenstein
Christian Apenzeller-Herzog
Andrej Isaak
author_facet Malgorzata Lea Jonczy
Lorenz Büchler
Yadusha Mahenthiran
Fabrice Helfenstein
Christian Apenzeller-Herzog
Andrej Isaak
author_sort Malgorzata Lea Jonczy
collection DOAJ
description Background: Bursitis iliopectinea (BI) is a condition that is characterized by swelling of the iliopsoas bursa, leading to compression of inguinal neurovascular structures, causing swelling, pain, paresthesia, or thrombosis of the leg. Questions: Due to the rare occurrence of BI, the available literature consists of case reports. Our study aims to systematically review the literature for a comprehensive analysis of the etiology, treatment modalities, and clinical outcomes of patients with BI. Methods: We systematically analyzed 217 studies with 502 cases of BI and extracted information about the terminology, risk factors, diagnostic and treatment strategies, association with neurovascular compression syndromes, treatment outcomes, and recurrence rates. Results: The overall quality of the analyzed studies was moderate to good. The terminology uses for BI was heterogeneous and included ganglion, tumor, mass, and bursitis. In addition to conventional X-ray, ultrasound, CT, or MRI were used to diagnose BI. The most prevalent etiology of BI was osteoarthritis of the hip or wear-related soft-tissue reactions after total hip replacement (THA). Nearly one-third of the patients suffered from compression syndromes, most frequently of the femoral vein (16%). Only rheumatoid arthritis showed an association with the occurrence of compression syndromes. The most common operative treatments were the resection of the bursa (30%), total hip arthroplasty (29%), and aspiration (24%). Use of analgesics (17%), injection of corticoids (11%), and physiotherapy (9%) were used for conservative treatments. The recurrence rate was highest after physiotherapy (OR: 4.1) or aspiration (4.5) and lowest after THA (OR: 0.2). Conclusions: Although BI is a condition commonly associated with hip arthritis or local tissue reactions following total hip prosthesis, its impact extends beyond typical hip-related symptoms. Notably, BI related to rheumatoid arthritis shows a high correlation with neurovascular compression symptoms, with femoral vein compression being the most frequently reported. This underscores the necessity of considering BI in patients presenting with nonspecific inguinal pain or neurovascular symptoms of the lower extremity. Additionally, standardizing the nomenclature of BI nomenclature could improve future research.
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spelling doaj-art-a9708d1ce1f744ffbe36450ef407eb9e2025-02-03T10:04:12ZengSAGE PublishingSAGE Open Medicine2050-31212025-02-011310.1177/20503121251317899Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic reviewMalgorzata Lea Jonczy0Lorenz Büchler1Yadusha Mahenthiran2Fabrice Helfenstein3Christian Apenzeller-Herzog4Andrej Isaak5Faculty of Medicine, University of Basel, Basel, SwitzerlandDepartment of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, SwitzerlandDepartment of Internal Medicine, Spital Langenthal, Langenthal, SwitzerlandDivision of Angiology, Department of Clinical Research, University of Bern, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, Bern, SwitzerlandUniversity Medical Library, University of Basel, Basel, SwitzerlandDepartment of Vascular Surgery, University Hospital Basel, Basel, SwitzerlandBackground: Bursitis iliopectinea (BI) is a condition that is characterized by swelling of the iliopsoas bursa, leading to compression of inguinal neurovascular structures, causing swelling, pain, paresthesia, or thrombosis of the leg. Questions: Due to the rare occurrence of BI, the available literature consists of case reports. Our study aims to systematically review the literature for a comprehensive analysis of the etiology, treatment modalities, and clinical outcomes of patients with BI. Methods: We systematically analyzed 217 studies with 502 cases of BI and extracted information about the terminology, risk factors, diagnostic and treatment strategies, association with neurovascular compression syndromes, treatment outcomes, and recurrence rates. Results: The overall quality of the analyzed studies was moderate to good. The terminology uses for BI was heterogeneous and included ganglion, tumor, mass, and bursitis. In addition to conventional X-ray, ultrasound, CT, or MRI were used to diagnose BI. The most prevalent etiology of BI was osteoarthritis of the hip or wear-related soft-tissue reactions after total hip replacement (THA). Nearly one-third of the patients suffered from compression syndromes, most frequently of the femoral vein (16%). Only rheumatoid arthritis showed an association with the occurrence of compression syndromes. The most common operative treatments were the resection of the bursa (30%), total hip arthroplasty (29%), and aspiration (24%). Use of analgesics (17%), injection of corticoids (11%), and physiotherapy (9%) were used for conservative treatments. The recurrence rate was highest after physiotherapy (OR: 4.1) or aspiration (4.5) and lowest after THA (OR: 0.2). Conclusions: Although BI is a condition commonly associated with hip arthritis or local tissue reactions following total hip prosthesis, its impact extends beyond typical hip-related symptoms. Notably, BI related to rheumatoid arthritis shows a high correlation with neurovascular compression symptoms, with femoral vein compression being the most frequently reported. This underscores the necessity of considering BI in patients presenting with nonspecific inguinal pain or neurovascular symptoms of the lower extremity. Additionally, standardizing the nomenclature of BI nomenclature could improve future research.https://doi.org/10.1177/20503121251317899
spellingShingle Malgorzata Lea Jonczy
Lorenz Büchler
Yadusha Mahenthiran
Fabrice Helfenstein
Christian Apenzeller-Herzog
Andrej Isaak
Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review
SAGE Open Medicine
title Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review
title_full Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review
title_fullStr Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review
title_full_unstemmed Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review
title_short Epidemiology, clinical manifestation, diagnosis,and treatment of bursitis iliopectinea: A systematic review
title_sort epidemiology clinical manifestation diagnosis and treatment of bursitis iliopectinea a systematic review
url https://doi.org/10.1177/20503121251317899
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