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

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
SAGE Open Medicine Pub Date : 2025-02-03 eCollection Date: 2025-01-01 DOI:10.1177/20503121251317899
Malgorzata Lea Jonczy, Lorenz Büchler, Yadusha Mahenthiran, Fabrice Helfenstein, Christian Appenzeller-Herzog, Andrej Isaak
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Abstract

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.

髂耻滑囊炎的流行病学、临床表现、诊断和治疗:系统综述。
背景:髂鞘滑囊炎(BI)是一种以髂腰肌滑囊肿胀为特征的疾病,导致腹股沟神经血管结构受到压迫,引起肿胀、疼痛、感觉异常或腿部血栓形成。问题:由于BI的罕见发生,可用的文献包括病例报告。我们的研究旨在系统地回顾文献,对BI患者的病因、治疗方式和临床结果进行全面分析。方法:我们系统地分析了217项研究的502例BI病例,并提取了有关术语、危险因素、诊断和治疗策略、与神经血管压迫综合征的关系、治疗结果和复发率的信息。结果:所分析研究的总体质量为中等至良好。BI的术语使用是不同的,包括神经节、肿瘤、肿块和滑囊炎。除常规x线外,超声、CT或MRI也可用于诊断BI。BI最常见的病因是髋关节骨关节炎或全髋关节置换术(THA)后磨损相关的软组织反应。近三分之一的患者患有压迫综合征,最常见的是股静脉(16%)。只有类风湿关节炎显示与压迫综合征的发生有关。最常见的手术治疗是滑囊切除术(30%)、全髋关节置换术(29%)和抽吸(24%)。保守治疗采用镇痛药(17%)、皮质激素注射(11%)和物理治疗(9%)。复发率最高的是物理治疗(OR: 4.1)或抽吸(OR: 4.5),最低的是THA (OR: 0.2)。结论:尽管BI通常与髋关节关节炎或全髋关节假体术后局部组织反应相关,但其影响超出了典型的髋关节相关症状。值得注意的是,与类风湿关节炎相关的BI与神经血管压迫症状高度相关,其中以股静脉压迫最为常见。这强调了在出现非特异性腹股沟疼痛或下肢神经血管症状的患者中考虑BI的必要性。此外,规范BI术语的命名法可以改善未来的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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