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Ultrasound signs of periarticular pathology
Last reviewed: 04.07.2025
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Bursitis.
They occur with inflammation of the bursa or frequent microtraumatization. The contents of the bursa, if large, can cause compression, discomfort, and pain. As a result, this leads to limited movement. Clinically, bursitis manifests itself as a volumetric formation. Bursitis must be differentiated from inguinal and femoral hernia, hematoma, femoral artery aneurysm, arteriovenous fistula, lymphocele, lymphadenopathy, thrombophlebitis, abscess, metastases to the lymph nodes, tumors, and other pathological processes.
Iliolumbar bursitis. It can reach enormous sizes up to the lesser trochanter, into the lesser pelvis below the inguinal ligament, anteriorly into the pubis. Large bursitis is easier to examine in panoramic scanning mode. In old bursitis, the contents are ironized and become dense, its echogenicity increases.
Complications are rare, but cases of rupture and infection of the joint capsules have been described.
Trochanteric bursitis. Manifested by accumulation of fluid in the space above the greater trochanter.
When fluid accumulates between the ischial tuberosity and the gluteus maximus muscle, ischiogluteal bursitis occurs, which can be the cause of pain in the gluteal region. The echographic manifestations are similar to those described above.
Muscle tears, muscle injuries, tendon and ligament tears.
Traumatic injuries to the hip area are less common than to the knee and shoulder joints. In car accidents, the rectus femoris is most often damaged. Athletes often have microtraumas to the rectus femoris. Symphysis pain in football players is often associated with a stretch or rupture of the adductor muscles attached to the pubic bones.
Hematomas of the thigh and gluteal region.
The subcutaneous fat layer on the thigh and buttocks is usually well defined. The tissue of this area contains few connective tissue partitions and is relatively weakly connected to the fascia, so blows to the thigh and buttocks relatively easily cause hematomas both in the thickness of the tissue and in the subfascial space.
Hematomas can reach large sizes, especially if the blow was tangential.
During an ultrasound examination, it is necessary to assess the size and depth of the hematoma to determine the best place to evacuate the contents during a puncture.
Developmental anomalies.
The most common anomalies include hip dysplasia, which is easily diagnosed in newborns and in the first 3-6 months after birth.
With proper correction, any deviations are rarely detected later.
Without proper correction, hip displacement and formation of a false acetabulum may occur. In this case, asymmetry in the formation of the femur is noted compared to the healthy limb.