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.
1
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.2
MR plays an important role in diagnosing and detecting the lesion.2
Treatment options include surgical excision, aspiration and filling with a mixture of a cortico-steroid and local analgesic.3
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
- Typical MRI findings of bilateral ischial bursitis: bilateral Weaver's bottom.BMJ Case Rep. 2021; 14e246665
- Ischiogluteal bursitis: a report of three cases with MR findings.Rheumatol Int. 2009; 29: 455-458
- Ischiogluteal bursitis. The pain in the arse.JAMA. 1974; 227: 551-552
Article info
Publication history
Published online: November 03, 2022
Accepted:
October 27,
2022
Received:
July 20,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
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