A Case of External Compression of Femoral Vein by the Enlarged Iliopsoas Bursa with Long Term Edema

Abstract

The iliopsoas bursa is the largest bursa in the region of hip joint. It is unusual that these bursa become symptomatic. However the bursa can compress femoral vein, leading to lower extremity edema. A 58-year-old man was referred to our department for his unilateral leg edema which had been treated as deep vein thrombosis without any favorable response. Magnetic resonance angiography was performed, which demonstrated enlarged iliopsoas bursa compressing his femoral vein. Surgical removal of the bursa was performed. The postoperative course was uneventful, and the patient is free from symptoms with no evidence of recurrence.

Keywords: femoral vein compression; iliopsoas bursa; lower extremity edema.

Fig. 1

(A) The preoperative patient’s lower extremities showing the larger circumference on the left. (B) CT scan shows a mass adjacent to the femoral vein mimicking intravenous thrombosis. (C) US shows incompressibility of the vein under compression, the presence of a slightly echogenic mass, which was confused with venous thrombosis, (D) MRA (true FISP) shows extrinsic iliopsoas bursa compressing the femoral vein clearly.

Fig. 2

(A) The bursa 30 mm × 20 mm in diameter was recognized around the femoral vein. (B) The content of bursa was viscous fluid.