Bursitis on the front of the hip joint

Anatomy: Between the deep hip flexor and the joint capsule is a large bursa (bursa iliopectinea), with the function to reduce the load on the muscle, when it slips over the hip joint. The bursa often communicates with the hip joint.

Symptoms: Pain when applying pressure on the bursa, which occasionally (but far from always) may feel swollen. Pain is agravated upon activation of the deep flexor (flexing the hip joint).

Acute treatment: Click here.

Examination: In light cases with only minimal tenderness medical examination is not necessarily required. In case of more pronounced pain or lack of progress a medical examination should be carried out to ensure that the diagnosis is correct and commence any treatment. The diagnosis is most easily and quickly made with ultrasound (which allows simultaneous treatment) (article).

Treatment: The treatment primarily comprises relief. The treatment can be supplemented with rheumatic medicine (NSAID) or injection of corticosteroid in the bursa preceded by draining of the bursa, which can advantageously be done under ultrasound guidance (article).

Complications: If progress is not smooth the correctness of the diagnosis or whether complications have arisen, should be considered:

• Degenerative arthritis in the hip joint
• Rupture of the superficial hip flexor (ruptura musculus rectus femoris)
• Rupture of the deep hip flexor (ruptura musculus iliopsoas)
• Outer snapping hip
• Inner snapping hip
• Fluid accumulation in the joint (traumatic synovitis/coxitis)
• Stress fracture of the femoral neck
• Inguinal hernia
• Inflammation of the adductor muscle of the thigh (tendinitis m adductor longus)
• Rupture of the adductor muscle of the thigh (ruptura m adductor longus)
• Rupture of the abdominal muscle fastening on the pubic bone (ruptura m rectus abdominis)
• Inflammation of the pubic bone joint (osteitis pubis)
• Nerve entrapment
• Lumbago

Special: Shock absorbing shoes or inlays will reduce the load.