Periarticular and extra-articular fluid collections around the hip can be a source of hip pain. The greater trochanteric bursa and the iliopsoas bursa are the major bursa of the hip, which can be evaluated with ultrasound.
Both iliopsoas and trochanteric bursitis is demonstrated on ultrasound as an enlarged, anechoic or hypoechoic bursa when compared with the contralateral, asymptomatic hip (Figs. 4, 5) . Fluid distension of the bursa may be asymptomatic; that is, non-tender when pressure is applied over the bursa with the transducer during sonographic imaging. In symptomatic cases, ultrasound can be used to guide bursal aspiration and injection of steroids.
Ischial bursitis can also be documented with sonography by its typical location, thin-walled compressible cystic lesion that can contain internal septa, and mural nodules . Sonography has some advantages over CT or MRI, which include the ability to assess the compressibility under real-time examination, lack of radiation, and the lower cost. MRI provides a more global evaluation of the articular, bony and soft tissues around the hip, however.
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