The ischiogluteal bursa is an inconsistent anatomic finding, located between the ischial tuberosity and the gluteus maximus. When a bursa becomes inflamed, it appears as a red swelling near a joint and may present as a soft-tissue mass. Though a rare condition, ischiogluteal bursitis (IB) may perforate and appear as a skin ulcer with a deep pocket mimicking a decubitus ulcer. Since IB has no specific clinical features, radiologic imaging and pathologic analysis are helpful in the diagnosis. Magnetic resonance imaging and computed tomography scans show an irregularly thickened wall with contrast enhancement attached to the ischial tuberosity.1 Pathologic specimens show the walls of the cyst to have fingerlike projections consisting of fibrous connective tissues and inflammatory cell infiltration. The lining of the cyst comprises a few layers of synovial or eosinophilic fibrinoid material.2 Since IB resists conventional antiulcer therapy, complete resection of the bursa is required, and in some cases flap surgery must be performed to provide a secure cushion.3
Clinical and magnetic resonance imaging (MRI) photographs of patients 1 (A and C) and 2 (B and D). A and B, Ulcerations in the left buttocks measured 45 × 45 mm with a 50-mm-deep pocket and 30 × 20 mm with a 50-mm-deep pocket, respectively. C and D, Contrast-enhanced T1-weighted MRI shows ringlike enhancement of the cavity wall (arrows); the arrowheads indicate ischial tuberosity.
Hematoxylin-eosin staining of surgical pathologic specimens from patients 1 (A and C) and 2 (B and D). A and B, Cyst walls consisting of fibrous connective tissues, numerous blood vessels, and chronic inflammatory cells (original magnification ×40). C and D, Walls of the cysts have fingerlike projections; the linings of the cysts are composed of a few layers of synovium; and walls of the vessels in the cyst wall are thickened (original magnification ×200).
Thank you for submitting a comment on this article. It will be reviewed by JAMA Dermatology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 12
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.