Ischiogluteal Bursitis Research Articles

Cutaneous metaplastic synovial cyst in the buttock: A comprehensive analysis of etiologic, clinical, ultrasonic, and pathological aspects

Abstract Cutaneous metaplastic synovial cyst (CMSC) is a rare cutaneous cystic lesion, which frequently occurs subsequent to trauma or surgery, forming through the reparative and healing process. It is often misdiagnosed as foreign body granuloma or recurrent epidermoid cyst. Histologically, it is characterized by a cystic structure with multiple villous projections pointing toward the cystic space, lined by cells resembling hyperplastic synovium. To date, only 32 cases have been reported in the English literature. In this article, we present two cases of CMSC with distinctive clinical features and ultrasonic findings. Furthermore, we found only three case reports of CMSC in the gluteal region. All of these cases were elderly patients and developed CMSC at the medial aspect of the buttock. Based on their unique clinical and ultrasonic characteristics, we propose that CMSC in the buttock may be considered a distinct subgroup within CMSC, demonstrating a spectrum of degenerative diseases along with ischiogluteal bursitis.

Surgical Excision for Refractory Ischiogluteal Bursitis: A Consecutive Case Series of 21 Patients.

A response to conservative treatment is usually obtained in cases of ischiogluteal bursitis. However, the time required to achieve relief of symptoms can vary from days to weeks, and there is a high recurrence rate, thus invasive treatment in addition to conservative treatment can occasionally be effective. Therefore, the aim of this study was to examine surgical excision in cases of refractory ischiogluteal bursitis and to evaluate patients' progression and outcome. A review of 21 patients who underwent surgical excision for treatment of ischiogluteal bursitis between February 2009 and July 2020 was conducted. Of these patients, seven patients were male, and 14 patients were female. Injection of steroid and local anesthetic into the ischial bursa was administered at outpatient clinics in all patients, who and they were refractory to conservative treatment, including aspiration and prescription drugs. Therefore, surgery was considered necessary. Excisions were performed by two orthopedic specialists using a direct vertical incision on the ischial area. A review of each patient was performed after excision, and quantification of the outcomes recorded using clinical scoring systems was performed. The results of radiologic evaluation showed that the mean lesion size was 6.2 cm×4.5 cm×3.6 cm. The average disease course after excision was 21.6 days (range, 15-48 days). Measurement of clinical scores, including the visual analog scale and Harris hip scores, was performed during periodic visits, with scores of 0.7 (range, 0-2) and 98.1 (range, 96-100) at one postoperative month, respectively. Surgical excision, with an expectation of favorable results, could be considered for treatment of ischiogluteal bursitis that is refractory to therapeutic injections, aspirations, and medical prescriptions, particularly in moderate-to-severe cases.

Left Gluteal Maximus Neuroma Causing Long-Standing Gluteal Pain.

Diagnosing buttock pain is a challenge due to complex anatomy and multiple causes. Potential pathologies range from common and benign to rare and life-threatening. Common causes for buttock pain include referred pain from the lumbar spine and sacroiliac joint, hamstring origin tendinopathy, myofascial pain, ischiogluteal bursitis, gluteal pathology, and piriformis syndrome. Rarer causes include malignancy, bone infection, vascular anomalies, and spondyloarthropathies. Other conditions may be present concurrently in the lumbar and gluteal area, which can cloud the clinical picture. Correct diagnosis and early treatment may improve quality of life by providing a targetable reason for their distress, improving pain, and allowing the patient to get back to their activities of daily living. When treating a patient with buttock pain, it is essential to reevaluate the diagnosis when symptoms fail to improve despite appropriate intervention.Here, we discuss a case of a peripheral nerve sheath tumor found in the left gluteus medius muscle of a patient that caused persistent, debilitating buttock pain. After years of treatment for piriformis syndrome and possible spinous causes, the patient was ultimately diagnosed with a peripheral nerve sheath tumor through magnetic resonance imaging with contrast. Peripheral nerve sheath tumors are a diverse group of mostly benign tumors that can occur sporadically or associated with certain disease processes. These tumors usually present with pain, a soft tissue mass, or focal neurological deficits. Upon removal of the tumor, her gluteal pain completely resolved.

Ischiogluteal bursitis – Is it common to find an undistended bursa?

Ischiogluteal bursitis – Is it common to find an undistended bursa?

Ischiogluteal bursitis: A not to be forgotten differential of gluteal lesions with fluid-fluid levels

Ischiogluteal bursitis, also called “weaver’s bottom,” arises due to chronic irritation of the soft tissues overlying the ischial tuberosity. Here, we report a case, in which multiple fluid-fluid levels were seen in a patient with bilateral ischiogluteal bursitis. The previous studies have suggested that ischiogluteal bursitis presents as a cystic lesion at its characteristic location. However, the presence of multiple fluid-fluid levels within the inflamed bursa may confuse young radiologists. To make things worse, a list of differentials for soft-tissue lesions with fluid-fluid levels often omits this common yet often overlooked condition.

Effects of Inflammatory Disease on Clinical Progression and Treatment of Ischiogluteal Bursitis: A Retrospective Observational Study.

Introduction:The symptoms of Ischiogluteal Bursitis (IGB) are often nonspecific and atypical, and its diagnosis is more challenging. Moreover, it is difficult to predict cases of chronic progression or poor treatment response. Therefore, the aim of this study was to investigate the clinical course of IGB patients and identify factors that are predictive of failure of conservative treatment.Materials and Methods:Our study consisted of IGB patients diagnosed between 2010 March and 2016 December who had been followed-up for at least one year. Structured questionnaires and medical records were reviewed to analyse demographic characteristics, lifestyle patterns, blood tests, and imaging studies. We categorized the cases into two groups based on the response to conservative treatment and the need for surgical intervention.Results:The most common initial chief symptoms were buttock pains in 24 patients (37.5%). Physical examinations showed the tenderness of ischial tuberosity area in 59 (92.2%) patients, but no specific findings were confirmed in 5 patients (7.8%). 51 patients (79.7%) responded well to the conservative management, 11 patients (17.2%) needed injection, and 2 patients (3.1%) had surgical treatment performed due to continuous recurrence. There was no difference in demographic and blood lab data between the two groups. However, the incidence of inflammatory diseases (response group: 10.3% vs non-response group: 66.7%, p=0.004) was significantly different between the two groups.Conclusion:The diagnosis of IGB can be missed due to variations in clinical symptoms, and cautions should be exercised in patients with inflammatory diseases as conservative treatment is less effective in them, leading to chronic progression of IGB.

Fungal Abscess Mimicking Ischiogluteal Bursitis With Rice Bodies.

Fungal Abscess Mimicking Ischiogluteal Bursitis With Rice Bodies.

Ischial Pain and Sitting Disability Due to Ischiogluteal Bursitis: Visual Vignette

Ischial bursitis or ischiogluteal bursitis is the inflammation of the ischiogluteal bursa due to excessive or inappropriate physical exercise, prolonged sitting, running, repetitive jumping, and kicking. Since ischial bursitis is a rare, infrequently recognized pathology and is difficult to differentiate from the soft tissue disease and tumors (both malignant and benign), herein exemplified is a case with ischiogluteal bursitis whereby the role of magnetic resonance imaging (MRI) in the prompt diagnosis has been highlighted.

Poster 214 Ischiogluteal Bursitis Misdiagnosed as Piriformis Syndrome in First Trimester Pregnancy: A Case Report

Poster 214 Ischiogluteal Bursitis Misdiagnosed as Piriformis Syndrome in First Trimester Pregnancy: A Case Report

The hamstring syndrome in endurance athletes

Hamstring syndrome is a gluteal sciatic pain, in which posttraumatic or congenital hard fibrotic bands irritate sciatic nerve at the insertion site of hamstring muscles to ischial tuberosity. Traction, mechanical...

Perforated Ischiogluteal Bursitis Mimicking a Gluteal Decubitus Ulcer in Patients With Spinal Cord Injury: Report of 2 Cases

Perforated Ischiogluteal Bursitis Mimicking a Gluteal Decubitus Ulcer in Patients With Spinal Cord Injury: Report of 2 Cases

Ischiogluteal bursitis: a report of three cases with MR findings

Ischiogluteal bursitis is an uncommon disorder which can be confused with neoplastic conditions in the buttock. Three cases of ischiogluteal bursitis in a 57-year-old man, a 73-year-old woman and a 73-year-old man are presented. All patients presented with a gradually increasing, painful buttock mass. Magnetic resonance imaging (MRI) revealed a soft tissue mass around the ischial tuberosity and showed various features in the three cases. Two patients underwent excision of the lesion, which was histologically diagnosed as ischiogluteal bursitis. One patient was conservatively treated and the symptoms gradually decreased. MRI was very useful in diagnosing and detecting the lesion. Ischiogluteal bursitis should be considered in the differential diagnosis of a buttock mass.

La bursopathie ischiatique

Ischiogluteal bursitis is a rare and infrequently recognized lesion. We report this case in a young woman cyclist. The patient described a painful mass of the buttock. The diagnostic is clinical and confirmed by ultrasonography and MRI. The treatment consists in a suspension of the sport and nonsteroidal anti-inflammatory drugs.

Non-Infectious Ischiogluteal Bursitis: MRI Findings

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.

HAMSTRING INJURY ??? TAE KWON DO

HISTORY A 14-year old male competitive Tae Kwon Do participant presented with right buttock and posterior thigh pain for over 1 year. He recalled the onset of pain following a high fast kick with his right leg. The coach and athlete attributed the pain to a pulled hamstring and treated it with ice and rest with some relief. After approximately 10 months of the pain he took 2 weeks off from Tae Kwon Do. The pain returned immediately upon returning to Tae Kwon Do. He received 24 sessions of intense physical therapy. The pain was elicited with high kicks and aggressive flexion of the right lower extremity. The pain was fairly constant during Tae Kwon Do practice. No radiation of pain to his lower extremities. No pain with sitting, standing or walking. No paresthesia or weakness. PHYSICAL EXAM Normal gait. Tenderness over the right ischial tuberosity. Pain with active and passive elevation of the right lower extremity to approximately 45 degrees while lying supine. Pain on resisted extension of right hip. There was no tenderness over the pyriformis. Hips range of motion was normal. Slump test was negative. Lower extremities: motor, sensory, and DTR's were normal. No muscle atrophy. L/S spine was normal. DIFFERENTIAL DIAGNOSIS Pyriformis syndrome. Referred pain from lumbo-sacral spine. Stress fracture of the ischium or pubic ramus. Ischial tubersoity avulsion. Compartment syndrome of the posterior thigh. Ischio-gluteal bursitis. Hamstring strain. TESTS AND RESULTS Plain film of pelvis: Normal MRI of pelvis and right hip: -traction type erosion along the lateral aspect of the ischial tuberosity at the origin of the semimembranosus -non retracted undersurface tear with its epicenter at the lateral margin of the ischial tuberosity. FINAL/WORKING DIAGNOSIS Right hamstring tear at is origin. TREATMENT AND OUTCOMES Specific therapeutic exercise regimen. Specific modification of activities. Deep friction massage.

Ischiogluteal bursitis mimicking soft-tissue metastasis from a renal cell carcinoma

We report a case of ischiogluteal bursitis mimicking a soft-tissue metastasis from a renal cell carcinoma. A 66-year-old woman suffered from pain over the left buttock 6 months after she was operated on for renal cell carcinoma of the left kidney. CT of the abdomen and pelvis revealed a tumor-like lesion adjacent to the left os ischii, which was suspected to be a soft-tissue metastasis. Percutaneous biopsy revealed no evidence of malignancy, but the histopathological diagnosis of chronic bursitis.

Persistent Low Back Pain and Ischiogluteal Bursitis

To the Editor.— In the QUESTIONS AND ANSWERS section of the Jan 24/31, 1986, issue ofJAMA,1regarding the patient with persistent low back pain, we agree with Drs Taub and Crue that surgery is not indicated. Regarding the diagnosis in this 62-year-old woman, spinal stenosis is unlikely. In fact, the physical examination, roentgenograms, computed tomography, and electromyography revealed no evidence of neurologic dysfunction. Several diagnoses were suggested by Dr Taub; we would like to add ischiogluteal bursitis. The finding of tenderness in the distribution of the sciatic nerve was dismissed by Dr Crue as merely subjective. However, this finding is compatible with ischiogluteal bursitis, since this bursa overlies the sciatic nerve.2Other evidence for ischiogluteal bursitis in this woman is exacerbation of pain after sitting, the fact that low back pain is constant, and the fact that partial relief was achieved with nonsteroidal anti-inflammatory drugs. At this

Persistent Low Back Pain and Ischiogluteal Bursitis-Reply

In Reply.— The patient in question complained of low back pain, with exacerbation after sitting or It is most unusual for the pain of ischiogluteal bursitis to be manifest anywhere but in the buttock and to be exacerbated, rather than relieved, by standing. Tenderness over the sciatic nerve is a nonspecific finding. My response suggested no immediate therapy but indicated one specific therapeutic approach, radiofrequency facetal branch denervation, should a specific test, local analgesic facetal branch block, prove the origin of symptoms.

Weaver's Bottom

<h3>To the Editor.—</h3> I have just read "Ischiogluteal Bursitis: The Pain in the Arse" (227:551, 1974) by Swartout and Compere. This syndrome, ischiogluteal bursitis (weaver's bottom), has been described in several editions of<i>Christopher's Minor Surgery</i>(Philadelphia, W. B. Saunders Co). Ischiogluteal bursitis is one of the manifestations of gout and responds to treatment with colchicine, an opiate, and uricosuric drugs. It is well to remember that gout may affect any joint or bursa. I remember because I suffer from gout, and I have sat on weaver's bottom!

Ischiogluteal Bursitis

Ischiogluteal bursitis is an extremely painful disorder, characterized by pain over the center of the buttock and down the back of the leg. Probably a common disorder, it is rarely diagnosed and is easily confused with a herniated disk or even acute thrombophlebitis. Treatment is simple, the most important being three days of bed rest. A skillful injection into the bursa may be helpful. The patient may be left with weak leg muscles for many months.