Primary iliopsoas bursography in the diagnosis of disorders of the hip.

The iliopsoas bursa is a well-defined anatomic structure that has been involved in various diseases about the hip, including osteoarthritis, rheumatoid arthritis, pigmented villonodular synovitis, and synovial chondromatosis. Demonstration of the iliopsoas bursa using contrast material has been reported during hip arthrography and inadvertently during angiography, but no direct or primary methods of iliopsoas bursography have been reported. A technique of primary bursography under fluoroscopy is described wherein filling of the bursa with contrast material allowed the observation of movement of the iliopsoas musculotendinous unit across the front of the pelvis during motion of the hip. This technique, which was of significant benefit in determining the etiology of two cases of the snapping hip syndrome of the internal variety, is simple, easily reproducible, and has clinical application.