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Obturator Externus Bursa: Anatomic Origin and MR Imaging Features of Pathologic Involvement¹

¹ From the Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, 600 University Ave, Toronto, Ontario, Canada M5G 1X5 (P.R., L.M.W.); and the Departments of Clinical Anatomy (A.A.) and Orthopedic Oncology, Mount Sinai Hospital, University of Toronto, Canada (J.W., R.S.B.). From the 2001 RSNA scientific assembly. Received July 8, 2002; revision requested August 14; revision received October 21; accepted November 22. Address correspondence to L.M.W. (e-mail: lwhite@mtsinai.on.ca).

View larger version (155K): [in a new window]   Figure 1. Illustration of a dissected hip joint (posterior view) shows hip synovium (curved arrows) protruding from the margin of the ischiofemoral capsular ligament (straight arrow). (Reprinted, with permission, from reference 11.)

View larger version (158K): [in a new window]   Figure 2. Photograph of a dissected cadaver hip. Posterior inferior view with the tendon (*) of the obturator externus muscle elevated shows the communication of the bursa (arrow) with the hip joint.

View larger version (126K): [in a new window]   Figure 3a. T2-weighted fat-suppressed fast SE MR images (4,166/104) obtained in a patient with synovial osteochondromatosis of the left hip. (a) Coronal MR image shows a hip effusion with fluid and capsular synovitis (arrows) that extends medially and inferiorly and displaces the obturator externus muscle (*) inferiorly. (b) Transverse MR image shows the bursa (*) extending along the plane of the obturator externus muscle and separate from the inferior hip capsule (arrows).

View larger version (121K): [in a new window]   Figure 3b. T2-weighted fat-suppressed fast SE MR images (4,166/104) obtained in a patient with synovial osteochondromatosis of the left hip. (a) Coronal MR image shows a hip effusion with fluid and capsular synovitis (arrows) that extends medially and inferiorly and displaces the obturator externus muscle (*) inferiorly. (b) Transverse MR image shows the bursa (*) extending along the plane of the obturator externus muscle and separate from the inferior hip capsule (arrows).

View larger version (150K): [in a new window]   Figure 4a. (a) Conventional coronal T1-weighted SE (583/8) and (b) T2-weighted fat-suppressed fast SE (4,166/104) MR images obtained in a patient with osteoarthritis of the right hip show a small obturator externus bursa with fluid and synovitis. The bursa extends medially (solid arrows) and indents the obturator externus muscle (open arrow). (c) Transverse T2-weighted fat-suppressed fast SE MR image (4,166/104) shows the bursa (large arrow) extending along the plane of the obturator externus muscle and separate from the inferior hip capsule (small arrows).

View larger version (130K): [in a new window]   Figure 4b. (a) Conventional coronal T1-weighted SE (583/8) and (b) T2-weighted fat-suppressed fast SE (4,166/104) MR images obtained in a patient with osteoarthritis of the right hip show a small obturator externus bursa with fluid and synovitis. The bursa extends medially (solid arrows) and indents the obturator externus muscle (open arrow). (c) Transverse T2-weighted fat-suppressed fast SE MR image (4,166/104) shows the bursa (large arrow) extending along the plane of the obturator externus muscle and separate from the inferior hip capsule (small arrows).

View larger version (135K): [in a new window]   Figure 4c. (a) Conventional coronal T1-weighted SE (583/8) and (b) T2-weighted fat-suppressed fast SE (4,166/104) MR images obtained in a patient with osteoarthritis of the right hip show a small obturator externus bursa with fluid and synovitis. The bursa extends medially (solid arrows) and indents the obturator externus muscle (open arrow). (c) Transverse T2-weighted fat-suppressed fast SE MR image (4,166/104) shows the bursa (large arrow) extending along the plane of the obturator externus muscle and separate from the inferior hip capsule (small arrows).

View larger version (188K): [in a new window]   Figure 5a. Sequential sagittal T2-weighted fat-suppressed fast SE MR images (4,166/104) obtained in a patient with avascular necrosis of the femoral head show a hip effusion with obturator externus bursal extension. (a) A posterior communication (arrows) with the hip joint is seen. (b-d) Sequential images extending medially show the bursa (arrow) at different positions along the obturator externus muscle.

View larger version (201K): [in a new window]   Figure 5b. Sequential sagittal T2-weighted fat-suppressed fast SE MR images (4,166/104) obtained in a patient with avascular necrosis of the femoral head show a hip effusion with obturator externus bursal extension. (a) A posterior communication (arrows) with the hip joint is seen. (b-d) Sequential images extending medially show the bursa (arrow) at different positions along the obturator externus muscle.

View larger version (203K): [in a new window]   Figure 5c. Sequential sagittal T2-weighted fat-suppressed fast SE MR images (4,166/104) obtained in a patient with avascular necrosis of the femoral head show a hip effusion with obturator externus bursal extension. (a) A posterior communication (arrows) with the hip joint is seen. (b-d) Sequential images extending medially show the bursa (arrow) at different positions along the obturator externus muscle.

View larger version (203K): [in a new window]   Figure 5d. Sequential sagittal T2-weighted fat-suppressed fast SE MR images (4,166/104) obtained in a patient with avascular necrosis of the femoral head show a hip effusion with obturator externus bursal extension. (a) A posterior communication (arrows) with the hip joint is seen. (b-d) Sequential images extending medially show the bursa (arrow) at different positions along the obturator externus muscle.