Diagnosis of Illiopsoas Bursitis and Tendonitis

Iliopsoas tendinitis and/or bursitis are among the most under-reported and under-diagnosed conditions, because they are difficult to identify. People will often have the injury for months, before going to seek professional medical attention. These injuries are often associated with snapping hip syndrome (a snapping sensation when you move your hip that result from your tendon snapping over your hip/pelvic bones, or results from loose bodies in your hip joint), lumbar lordosis (swayback), degenerative or herniated lumbar discs, and/or other groin injuries (avulsion fractures, osteitis pubis, adductor tendonitis, sports hernia, nerve entrapment).

To help your doctor achieve a proper diagnosis, he/she will begin with a medical history about you, your current condition and symptoms. He/she will inquire about the intensity of your present pain, the duration of your symptoms and the limitations you are experiencing. Details about what instigated the problem, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, are very helpful in assessing your injury.

Most of the physical examination will focus on your abdomen, hip, pelvis, groin, lower back, upper thigh and genital area. Your doctor will visually assess and palpate (feel) your bones and soft tissue to evaluate sameness (symmetry), and recognize differences. This will help to discover any abnormalities, such as mild or severe inflammation, pain and tenderness, fluid, bone or tissue deformity, and weakened muscles. Your doctor will often look for an anterior pelvic tilt due to tight iliopsoas muscles. Your gait (the way you walk) and leg lengths will be examined, to test for tight hip flexors and/or other conditions.

Pain is often experienced when putting pressure on the groin femoral triangle (inguinal ligament on top, sartorius muscle on the outside, adductor longus muscle along the inside). Your doctor will often ask you to flex your knee or hip and turn your leg outward against resistance, lie down and raise your heels while legs are straight 15 degrees off table, or move from a bent to straight position to test for hip restrictions, strength and pain. He/she will also listen for a popping noise heard with these motions.

Most Common Iliopsoas Injury Diagnostic Tests:

If you have iliopsoas tendinitis and/or bursitis or iliopsoas syndrome, you often don´t require additional tests.

X-rays will provide a two-dimensional image of the overall structure of your pelvis. They are helpful in identifying the position of the pelvis and/or any instability, abnormal bone shapes (bone spurs or bone cysts, wear and tear on the joints), avulsion fractures (when a fragment of bone tears away from the main bone along with the soft tissue (muscle, tendon, ligament) as a result of trauma) and/or other groin or hip problems.

MRI and CT scans will provide more detailed information and will help to evaluate the soft tissues in and around your groin and pelvis (muscles, tendons, ligaments, fascia, and other connective tissues). They will show fluid next to the muscle, and may identify inflammation, tendinitis, tears and other associated groin conditions. They are generally used in more severe cases or to identify co-existing groin conditions.

Diagnostic Ultrasound (ultrasonography) can confirm diagnosis and demonstrate tissue disruption or thickened tendons. It is good for identifying bursitis and excessive fluid in bursa, and/or eliminating other causes of iliopsoas pain.

Blood tests can be ordered if rheumatoid arthritis is suspected as a cause of your iliopsoas tendinitis or bursitis.