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# Iliopsoas bursa

The iliopsoas bursa is a fluid sac between the main hip flexor tendon and the front of the hip joint; it sometimes opens into the joint.

Official name: Iliopectineal bursa

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## What it is

The iliopsoas (iliopectineal) bursa: the largest bursa around the hip, between the iliopsoas tendon and the front of the hip joint. It sometimes connects with the joint.

## What it does

Lets the iliopsoas tendon glide over the front of the pelvis and hip.

## Key points

- Opens into the hip joint in a minority of adults (often quoted around 15%), through a gap between the iliofemoral and pubofemoral ligaments; more often when the joint is diseased
- When distended it presents as a groin mass that can be mistaken for a hernia, an aneurysm or enlarged lymph nodes, and can compress the [femoral vein](https://durgical.com/en/anatomy/femoral-vein/) or femoral nerve
- Internal snapping hip: the iliopsoas tendon flicks over the iliopubic eminence or the femoral head, irritating the bursa

## Key facts

**Where**
Between iliopsoas tendon and anterior hip capsule, near iliopubic eminence

**Function**
Largest bursa around hip; reduces tendon friction; sometimes communicates with hip joint

## Relations

**In front**
[Iliopsoas tendon](https://durgical.com/en/anatomy/tendon-of-iliopsoas/); in front of it the [femoral nerve](https://durgical.com/en/anatomy/femoral-nerve/) laterally and the [femoral artery](https://durgical.com/en/anatomy/femoral-artery/) and vein medially

**Behind**
Anterior [hip capsule](https://durgical.com/en/anatomy/articular-capsule-of-hip-joint/) between the iliofemoral and pubofemoral ligaments, and the iliopubic eminence

**Above**
Pelvic brim and [inguinal ligament](https://durgical.com/en/anatomy/inguinal-ligament/); an enlarged bursa can extend up into the [pelvis](https://durgical.com/en/anatomy/region/pelvis/) along the iliopsoas

## How to find it

It lies deep in the groin, just below the middle of the inguinal ligament, behind the femoral vessels. It cannot be felt unless distended, when a soft groin swelling appears.

## Examination

- Moving the hip from flexion, abduction and external rotation into extension reproduces a clunk at the front of the hip in internal snapping hip

## On imaging

Ultrasound shows fluid in the bursa, the tendon gliding over the pelvis on dynamic scanning and any neck connecting it to the hip joint. MRI shows a fluid-filled sac along the iliopsoas; on arthrography it fills from the joint when the two connect.

## Common problems

- Iliopsoas bursitis: pain at the front of the hip or groin. It can fill with fluid in hip arthritis.

## Clinical notes

- Hip osteoarthritis, rheumatoid arthritis and wear debris after hip replacement can enlarge it through the joint connection
- Compression of the femoral vein by an enlarged bursa can cause leg swelling that mimics deep vein thrombosis
- After hip replacement, iliopsoas irritation against the front of the acetabular cup is a recognised cause of groin pain

## Test yourself

Think of the answer, then tap the question to see it.

## Where does the iliopsoas bursa lie, and how can it connect with the hip joint?

Between the iliopsoas tendon and the anterior hip capsule; it opens into the joint in a minority of adults through a gap between the iliofemoral and pubofemoral ligaments.

## What can a distended iliopsoas bursa be mistaken for?

A groin mass such as a hernia, an aneurysm or enlarged lymph nodes; it can also compress the femoral vein or femoral nerve.

## What causes internal snapping hip at the iliopsoas bursa?

The iliopsoas tendon flicking over the iliopubic eminence or the femoral head, irritating the bursa.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
bursa iliopectinea; bursa subtendinea iliaca TA2 2732

**Official Spanish (DeCS)**
Bolsa iliopectínea DeCS D002061

**English (TA2)**
Iliopectineal bursa

**Also called**
subtendinous bursa of iliopsoas

## Related

- [Hip capsule](https://durgical.com/en/anatomy/articular-capsule-of-hip-joint/)
- [Iliopsoas tendon](https://durgical.com/en/anatomy/tendon-of-iliopsoas/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=2094&filter=ths_termall&q=Bolsa%20Sinovial); [Anatomy, Skin Bursa](https://www.ncbi.nlm.nih.gov/books/NBK554438/); [Anatomy, Bony Pelvis and Lower Limb, Hip](https://www.ncbi.nlm.nih.gov/books/NBK526019/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/iliopectineal-bursa/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/iliopectineal-bursa/