Imaging features of reactive bursitis secondary to osteochondroma

The purpose of this study was to determine imaging features of reactive bursitis secondary to osteochondroma.

Fourteen patients with reactive bursitis secondary to osteochondroma were retrospectively reviewed.

The 14 patients were 11 males and 3 females ranging in age from 18 to 67 years (mean, 33.6 years). The locations were as follows: scapula (n = 2), lesser trochanter (n = 6), greater trochanter (n = 1), distal femur (n = 2), distal fibula (n = 1), iliac bone (n = 2). On CT, six bursae were hypodense and 1 was isodense compared to muscle. All bursae had a thickened wall, 6 contained multiple villous projections and septa. Five bursae contained a few calcifications. On enhanced CT, the bursa displayed mild enhancement of the wall, villous projections, and septa. On MRI, one bursa was hypointense, three were hyperintense, and 5 were isointense relative to muscles on T1-weighted images. All bursae were hyperintense relative to muscles on T2-weighted images. All bursae had a thickened wall, eight contained multiple villous projections and septa. In five bursae, a few fatty villous projections can be seen within the bursa. On enhanced MRI, all bursae displayed avid enhancement of the bursal wall, villous projections, and septa.

Reactive bursitis secondary to osteochondroma most often occurred in young male adults. The most common involved site is lesser trochanter. The imaging features is that of an irregular, thick-walled fluid-filled bursa overlying an osteochondroma that containing multiple villous projections and septa. Calcification and/or lipoma arborescens may be developed within the bursa. On contrast-enhanced images, the bursa shows enhancement of the bursal wall, villous projections and septa.