What could be causing a palpable tubular structure on the inside of my right hip?

Palpable Tubular Structure on Inner Right Hip

The most likely explanation for a palpable tubular structure on the inside of your right hip is your iliopsoas tendon, which is a normal anatomical structure that can sometimes be felt, especially in thin individuals, though other possibilities including enlarged lymph nodes, vascular structures (femoral artery/vein), or pathologic masses must be excluded through proper evaluation. 1

Initial Clinical Assessment

The "inside" of the hip typically refers to the anterior medial hip/groin region, where several tubular structures are normally present:

• Iliopsoas tendon: This is the most commonly palpable normal structure in this location, running from the pelvis across the hip joint 1
• Femoral artery and vein: These major blood vessels run through the femoral triangle in the inner hip/groin area and can be palpable, particularly the artery with its pulse 2
• Inguinal lymph nodes: When enlarged, these can present as palpable tubular or nodular structures in the groin 1

When to Seek Medical Evaluation

You should obtain a clinical examination if:

• The structure is new or has changed in size 2
• You have associated pain, swelling, or limitation of hip movement 1
• You notice skin changes, warmth, or redness over the area 1
• The structure is pulsatile (which would suggest a vascular structure or aneurysm) 2

Recommended Diagnostic Approach

If clinical examination raises concern, plain radiographs of the pelvis and hip should be obtained first as the initial screening test. 3, 4

Imaging Algorithm Based on Initial Findings:

• If radiographs are normal but symptoms persist: MRI of the hip without IV contrast is the next appropriate study, rated 9/9 for appropriateness by the American College of Radiology 4
• For suspected soft tissue abnormality (tendonitis, bursitis, muscle pathology): MRI hip without IV contrast is first choice, or ultrasound as a valuable alternative 1, 4
• Ultrasound can specifically evaluate: Iliopsoas tendon pathology, fluid collections, and can guide diagnostic injections if needed 1

Common Pitfalls to Avoid

• Do not assume a palpable structure is always pathologic: Normal anatomical structures like the iliopsoas tendon or femoral vessels can be palpable, especially in individuals with less subcutaneous tissue 2, 5
• Do not proceed directly to advanced imaging without clinical examination and plain radiographs first: This is not recommended and may lead to unnecessary testing 4
• Do not ignore associated symptoms: Pain, limitation of motion, or systemic symptoms warrant prompt evaluation 1

Specific Structures to Consider

Normal Anatomy:

• Iliopsoas tendon: Can be prominent and palpable, may cause "snapping hip" sensation if it moves over bony prominences 1
• Femoral neurovascular bundle: The femoral artery is normally palpable with a pulse in the femoral triangle 2

Pathologic Possibilities:

• Enlarged inguinal lymph nodes: Can present as palpable masses in the groin region 1
• Iliopsoas or subiliacus bursitis: Can create palpable swelling 1
• Paralabral cysts: Can extend and become palpable, though less common 1
• Vascular abnormalities: Including femoral artery aneurysm or pseudoaneurysm 2

A systematic physical examination by a healthcare provider, starting with inspection and palpation while standing, seated, supine, and during gait analysis, is essential to characterize this finding and determine if further workup is needed. 2, 5