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Weaver's bottom

Published:November 03, 2022DOI:https://doi.org/10.1016/j.amjms.2022.10.011

      Case presentation

      A 77-year-old woman presented with a 40-day history of gradually increasing mass in the left buttock, and she complained of pain on sitting. She reported having long term sedentary activities, like knitting and viewing TV. Physical examination revealed a soft and well-defined mass located in the left gluteal region, approximately 5 cm in diameter (Fig. 1A). Pelvis magnetic resonance (MR) demonstrated a thin-walled cystic lesion with high signal intensity on T2-weighted image, attached to the ischial tuberosity (Fig. 1B). Maximum intensity projection stereoscopically displayed the mass, measuring 8 × 6 × 4 cm, located inferior to the ischial tuberosity (Fig. 1C). The patient underwent excision of the mass. The mass had a thin, white to gray wall, containing a large amount of serous fluid. Histologic analysis revealed bursitis, showing a cyst wall consisting of fibrous and granulation tissue, hemorrhage and a small amount of chronic inflammatory cells (Fig. 1D). The patient was feeling well at 4 months of follow-up.
      Ischiogluteal bursitis, also referred to as Weaver's bottom, is mainly caused by synovitis and bursal effusion of the ischium, which usually affects adults and older populations.
      • Sharma R
      • Tiwari T
      • Goyal S.
      Typical MRI findings of bilateral ischial bursitis: bilateral Weaver's bottom.
      Risk factors include prolonged sitting, which may cause mechanical irritation on the ischial tuberosity. The condition should be considered in the differential diagnosis of a soft tissue neoplasm.
      • Hitora T
      • Kawaguchi Y
      • Mori M
      • et al.
      Ischiogluteal bursitis: a report of three cases with MR findings.
      MR plays an important role in diagnosing and detecting the lesion.
      • Hitora T
      • Kawaguchi Y
      • Mori M
      • et al.
      Ischiogluteal bursitis: a report of three cases with MR findings.
      Treatment options include surgical excision, aspiration and filling with a mixture of a cortico-steroid and local analgesic.
      • Swartout R
      • Compere EL.
      Ischiogluteal bursitis. The pain in the arse.

      Funding

      The author(s) received no financial support for the research, authorship, and/or publication of this article.

      Declaration of Competing Interest

      The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this manuscript.

      References

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