RS3PE Syndrome with Iliopsoas Bursitis Distinguished from an Iliopsoas Abscess Using a CT-guided Puncture

Intern Med. 2015;54(13):1653-6. doi: 10.2169/internalmedicine.54.4874. Epub 2015 Jul 1.

Abstract

A 55-year-old man was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. Contrast-enhanced computed tomography for cancer screening showed a mass with low-density centers with an enhanced rim in the left iliopsoas muscle. We suspected an iliopsoas abscess and performed computed-tomography-guided puncture of the mass. Both Gram staining and the culture of the fluid were negative. We diagnosed the patient with RS3PE syndrome with iliopsoas bursitis and administered low-dose corticosteroids without antibiotics. The symptoms, including left hip pain, quickly disappeared following treatment. Clinicians should be aware that iliopsoas bursitis may resemble an iliopsoas abscess. As a result, it is important to make an accurate differential diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Bursitis / complications
  • Bursitis / diagnosis*
  • Bursitis / drug therapy
  • Bursitis / pathology
  • Contrast Media / administration & dosage
  • Diagnosis, Differential
  • Edema / etiology
  • Humans
  • Male
  • Middle Aged
  • Prednisolone / therapeutic use*
  • Psoas Abscess / complications
  • Psoas Abscess / diagnosis*
  • Psoas Abscess / drug therapy
  • Psoas Abscess / pathology
  • Punctures / methods
  • Syndrome
  • Synovitis / etiology
  • Tomography, X-Ray Computed* / methods

Substances

  • Anti-Inflammatory Agents
  • Contrast Media
  • Prednisolone