Non-Infectious Ischiogluteal Bursitis: MRI Findings

Abstract

ObjectiveWe wished to report on the MRI findings of non-infectious ischiogluteal bursitis.Materials and MethodsThe MRI findings of 17 confirmed cases of non-infectious ischiogluteal bursitis were analyzed: four out of the 17 cases were confirmed with surgery, and the remaining 13 cases were confirmed with MRI plus the clinical data.ResultsThe enlarged bursae were located deep to the gluteus muscles and postero-inferior to the ischial tuberosity. The superior ends of the bursal sacs abutted to the infero-medial aspect of the ischial tuberosity. The signal intensity within the enlarged bursa on T1-weighted image (WI) was hypo-intense in three cases (3/17, 17.6%), iso-intense in 10 cases (10/17, 58.9%), and hyper-intense in four cases (4/17, 23.5%) in comparison to that of surrounding muscles. The bursal sac appeared homogeneous in 13 patients (13/17, 76.5%) and heterogeneous in the remaining four patients (4/17, 23.5%) on T1-WI. On T2-WI, the bursa was hyper-intense in all cases (17/17, 100%); it was heterogeneous in 10 cases and homogeneous in seven cases. The heterogeneity was variable depending on the degree of the blood-fluid levels and the septae within the bursae. With contrast enhancement, the inner wall of the bursae was smooth (5/17 cases), and irregular (12/17 cases) because of the synovial proliferation and septation.ConclusionIschiogluteal bursitis can be diagnosed with MRI by its characteristic location and cystic appearance.

Rare Form of Rheumatoid Nodule around Ischial Tuberosity Mimicking Ischiogluteal Bursitis

“…In our case, the nodule was cystic and extended deep into the gluteus maximus muscle, abutting on the surface of the ischial tuberosity, typical for ischiogluteal bursitis (7). However, histopathologic finding of the case, was composed of fibrinoid degeneration of collagen, surrounded by histiocytes and giant cell reaction, consistent with a rheumatoid nodule.…”

“…In our case report, the lesion revealed a cystic lesion, a nonspecific finding, which was observed in the bursitis and rheumatoid nodules with complete central necrosis (2,3,7). The typical location of the cystic lesion, deep into the gluteus maximus muscle and abutting the ischial tuberosity, implies ischiogluteal bursitis, rather than a rheumatoid nodule.…”

“…The lesion reveals hyperintense in T2-weighted images, hypointense in T1-weighted images, and peripheral rim enhancement on contrast-enhanced scan (7). The bursitis may reveal variable signal intensity in T1-and T2-weighted images, according to the content of the bursal sac.…”

F-18 FDG PET/CT Incidental Finding of Large Ischiogluteal Bursitis

“…1 Inflammatory involvement of this bursa may be related to underlying systemic or connective tissue diseases such as gout, rheumatoid arthritis, lupus erythematosus, ankylosing spondylitis, and Reiter syndrome. 2,3 Additional causes are chronic irritation and repetitive microtrauma from sedentary sitting position of weavers and in bedridden cachectic cancer patients. 1,2,4 Depending on the size and degree of inflammation, symptomatology may include sciatalgia-like pain and palpable mass.…”

Radiologic Imaging of Pelvis, Groin, Hip, and Thigh Injuries

“…Ischiogluteal bursitis is also best documented on MRI since it is located deep to the gluteus muscles and posteroinferior to the ischial tuberosity. The superior end of the bursal sac abuts the inferomedial aspect of the ischial tuberosity (Kil-Ho Cho et al 2004 ).…”