Unique Cause of Chronic Right Hip Pain and Unilateral Leg Swelling 10 Yrs Following Total Hip Arthroplasty

Patient is a 64-yr-old female with a history of right total hip arthroplasty who presented with progressive, painful right lower extremity edema and chronic groin pain for 2 years. A computed tomography scan from October 2021 revealed an expanding, large iliopsoas bursal fluid collection that caused compression of the right common femoral artery and vein in June 2023. Further workup excluded deep venous thrombosis or infectious causes. Iliopsoas fluid collections can result from various conditions such as a rare complication of total hip arthroplasty. This is likely due to mechanical irritation from the prosthetic components and was confirmed with resolution of symptoms after undergoing revision of total hip arthroplasty in 2024. This case highlights iliopsoas hematoma as a rare but important consideration in patients with unilateral lower extremity edema after total hip arthroplasty.