ABSTRACT
A 93-year-old man with a history of calcium pyrophosphate deposition disease (CPPD) in the right shoulder and wrist had severe pain in his right lower limb in the absence of trauma. He was transported by ambulance to our hospital. He was febrile (38℃) and swelling of the inguinal region was noted on physical examination. Laboratory examination showed elevated C-reactive protein (19.1 mg/dL, normal range ＜ 0.3 mg/dL) and white blood cell count (9600/μl, normal range ＜ 9000/μL). X-ray showed calcifications near the hip bilaterally, computed tomography showed distension of the iliopectineal bursa, and magnetic resonance imaging showed a cystic lesion of the iliopectineal bursa. Aspiration was performed under ultrasound guidance. Fluid analysis under an optical microscope revealed calcium pyrophosphate crystals. Bacterial examination was negative. Iliopectineal bursitis associated with CPPD was diagnosed, and he was treated conservatively with NSAIDs. To our knowledge, only 5 cases of iliopectineal bursitis associated with CPPD have been reported in Japan, and here we present the details of this rare case.
ABSTRACT
A bursite iliopectínea, embora não tenha muitos relatos na literatura, apresenta-se clinicamente com sinais e sintomas frequentemente encontrados nos ambulatórios e consultórios. Sua clínica é de dor na parte anterior do quadril que piora à extensão, abdução e rotação interna do mesmo. O diagnóstico é confirmado pelo ultrassom ou ressonância nuclear magnética do quadril. A bursite iliopectínea responde bem ao tratamento conservador com anti-inflamatório não hormonal e repouso. Devido a esta boa evolução, não raro, pode-se tratar uma bursite iliopectínea com sucesso sem se saber o que está tratando.
Although there are not many reports in literature, iliopectineal bursitis presents clinically with signs and symptoms frequently found in outpatient services and practice. Its clinical presentation is anterior hip pain that worsens with the extension, abduction and internal rotation of the hip. The diagnosis is confirmed by ultrasound or magnetic nuclear resonance imaging of the hip. The iliopectineal bursitis responds well to conservative treatment with non-hormonal anti-inflammatory drugs and rest. Due to its good evolution, it is not rare to treat iliopectineal bursitis successfully without even knowing what is being treated.