It’s Not Always the Appendix: An Unusual Case of Right Lower Quadrant Pain in an Emergency Department Patient Due to Iliopsoas Bursitis From Uncommon Sleep Positioning

Patients presenting to the emergency department (ED) with right lower quadrant pain will typically have acute appendicitis at the top of a limited differential. We present an unusual case of right lower quadrant pain in a 45-year-old female emergency department patient. She was referred from primary care for evaluation of suspected appendicitis with a final diagnosis of iliopsoas bursitis caused by sleep positioning. Knowledge of the appropriate evaluation and treatment of this unusual ED presentation is important for accurate diagnosis and appropriate referral to avoid unnecessary patient morbidity.