Can iliopsoas bursitis be an early indicator of advancing hip osteoarthritis?

Abstract

One of the most common causes of groin pain in older patients is hip joint arthritis. We present 2 patients in their 60’s with severe groin pain consistent with iliopsoas bursitis and mild hip joint arthritis. Co-existing iliopsoas bursitis in the setting of mild hip joint arthritis is a rare finding and this created diagnostic and therapeutic challenges. Medical records, imaging studies, and surgeries for 2 patients were reviewed. Both patients underwent ultrasound guided steroid aspirations and injections into both their iliopsoas bursa and hip joints yielding little benefit. Within several months both patients had radiographic progression of their degenerative arthritis leading to total hip replacement with relief of all symptoms. Coexisting iliopsoas bursitis and mild hip joint arthritis has not been widely reported in the literature. We propose that iliopsoas bursitis can be an early indicator for advancing hip osteoarthritis.