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PubMed1988

Anatomy of motion.

Review of muscle function during the walking gait cycle suggests that once the body is put in motion, its own kinetic force tends to keep it moving. This progression, however, must be controlled and stabilized by muscles acting on the limb segments during weight bearing. Primary, accelerating muscle action is most important during swing phase when the iliopsoas and quadriceps femoris bring the limb forward to maintain continuity of the gait cycle. Once the limb is in stance phase, most muscles exert controlling forces on the limb by decelerating movement of the limb segments and stabilizing the joints.

Biomechanical Phenomena↗
PubMed1997

Iliopsoas myositis mimicking appendicitis: MRI diagnosis.

Myositis of the truncal muscles can closely mimic acute appendicitis. Myositis is the early stage of muscular infection. It is characterized by diffuse muscular pain and swelling without a distinct mass. Early diagnosis of myositis improves the outcome and surgical debridement is usually avoided. Pyomyositis, the advanced stage of the disease, can be diagnosed by MRI examination. We present a case of early bacterial myositis that was diagnosed by MRI.

Acute Disease↗
PubMed1975

Paralytic dislocation of the hip in myelodysplasia. The role of the adductor transfer.

In thirty-nine patients with myelodysplasia at the third, fourth, or fifth lumbar level and subluxation or dislocation of the hip (fifty-nine hips involved), the following surgical approaches were utilized to balance the muscles about the hip: In one group (twenty hips in eleven patients) the origins of the adductors longus, brevis, and gracilis were transferred to the ischial tuberosity, and in fifteen hips in that group the iliopsoas also was transferred to the greater trochanter when the abductors were severely weakened. In the second group (thirty-nine hips in twenty-eight patients), only the iliopsoas transfer was done. Group I patients demonstrated improved muscle balance with less severe flexion-adduction contractures; increased power in abduction and extension; and a higher incidence of stable hips at follow-up.

Child↗
PubMed2002

Clinics in diagnostic imaging (71). Left iliopsoas abscess secondary to vertebral osteomyelitis.

A 26-year-old woman presented with a progressively painful lump at her left groin and upper thigh for five months. She also had intermittent back pain for three years. Radiographs and CT showed osteolytic destruction of the several contiguous thoracolumbar vertebrae with a large left iliopsoas abscess that extended to involve the left gluteus maximus and adductor magnus muscles. She responded well to a course of antibiotics. The role of imaging and imaging features of iliopsoas abscesses are discussed, together

Adult↗
PubMed2004

Muscular contributions to hip and knee extension during the single limb stance phase of normal gait: a framework for investigating the causes of crouch gait.

Crouch gait, a troublesome movement abnormality among persons with cerebral palsy, is characterized by excessive flexion of the hips and knees during stance. Treatment of crouch gait is challenging, at present, because the factors that contribute to hip and knee extension during normal gait are not well understood, and because the potential of individual muscles to produce flexion or extension of the joints during stance is unknown. This study analyzed a three-dimensional, muscle-actuated dynamic simulation of walking to quantify the angular accelerations of the hip and knee induced by muscles during normal gait, and to rank the potential of the muscles to alter motions of these joints. Examination of the muscle actions during single limb stance showed that the gluteus maximus, vasti, and soleus make substantial contributions to hip and knee extension during normal gait. Per unit force, the gluteus maximus had greater potential than the vasti to accelerate the knee toward extension. These data suggest that weak hip extensors, knee extensors, or ankle plantar flexors may contribute to crouch gait, and strengthening these muscles--particularly gluteus maximus--may improve hip and knee extension. Abnormal forces generated by the iliopsoas or adductors may also contribute to crouch gait, as our analysis showed that these muscles have the potential to accelerate the hip and knee toward flexion. This work emphasizes the need to consider how muscular forces contribute to multijoint movements when attempting to identify the causes of abnormal gait.

Acceleration↗
PubMed1985

Duration of stretching effect on range of motion in lower extremities.

The duration of the effect of contract-relax stretching on range of motion (ROM) in the lower extremities was measured on eight male volunteers. The stretching procedure was performed as one isometric contraction, followed by relaxation and then a passive extension of the muscle being stretched. The treated muscle groups were the adductors, hamstrings, rectus femoris, iliopsoas, gastrocnemius, and soleus. The total stretching time was 15min. Six ROMs were tested 0, 30, 60, and 90min after the stretching procedure. There was a significant increase in hip abduction (+17% +/- 3), knee flexion (+4% +/- 1), hip flexion (+4% +/- 2), ankle dorsiflexion with knee flexed (+18% +/- 7), and ankle dorsiflexion with knee straight (+16% +/- 5). The increase remained for 90min for all ROMs except for ankle dorsiflexion with the knee straight.

Humans↗
PubMed1984

Metastasis of malignant neoplasms to skeletal muscle.

Malignant neoplasms were found at 194 of 723 autopsies carried out at the Marqués de Valdecilla National Medical Center in the period 1980-1982, and in 50 of these there was secondary involvement of skeletal muscle. In 16 cases (8.2%) the primary tumour and/or its metastases had invaded skeletal muscle, but in 34 (17.5%) true macroscopic or microscopic metastases were present. It was this latter finding which prompted us to carry out a detailed analysis. Below are given the percentages of malignant neoplasms of each type in which the tumours had metastasized to skeletal muscle and, in brackets, the number of metastases found in skeletal muscle as a percentage of all metastatic tumours. Acute leukaemias 17.2% (14.7%), lymphomas 20.6% (17.6%), carcinomas 17.7% (64.6%): for the various sub-categories of carcinoma the figures were: epidermoid carcinoma 10% (5.8%), adenocarcinoma 29.6% (47%) and anaplastic carcinoma 5.8% (2.9%). The muscles most commonly involved were the diaphragm (67.6%) and the iliopsoas (29.4%). The patients ranged in age from 26 to 84 years, mean age 62.8 years. The male/female ratio was 2.8/1. In advanced cancer an appreciable percentage of metastases occur in skeletal muscle.

Adult↗
PubMed2004

Primary malignant tumors of the iliopsoas compartment.

BACKGROUND AND OBJECTIVES: Primary malignant tumors of the iliopsoas compartment are rare entities that have been infrequently reported. We present our experience of iliopsoas malignancy to better characterize and define the natural history of this condition. METHODS: Primary iliopsoas tumors occurring from January 1990 were identified from the Royal Marsden Hospital's (RMH) Sarcoma Unit prospective database. RESULTS: Nineteen malignant tumors (11 limited to the psoas muscle only, 1 involving only the iliacus muscle and 7 involving both the iliacus and psoas) of the iliopsoas compartment were evaluated and treated at the RMH during this period. Leiomyosarcoma (n = 5) and liposarcoma (n = 3) were the most frequent histologic types. There were 3 G1, 5 G2, 10 G3 tumors and grade could not be assessed in 1 patient. There were 17 T2 tumors and size was not available in 2 patients. Surgery was done in 14 patients (negative microscopic margins-7, positive microscopic margins-3, and positive gross margins-3 and the margin of excision was not known in 1 patient). Five of 14 surgically treated patients had local recurrence and 6 of 19 patients developed metastases. Ten patients died of their disease at a median follow-up of 12 months. The estimated 2 and 5 year survival rates were 44 and 23%, respectively. CONCLUSIONS: Tumors in this location have a poor prognosis due to the lack of early diagnosis, large size at presentation, multiple attachments of the psoas muscle, and being relatively surgically inaccessible.

Chemotherapy, Adjuvant↗
PubMed1980

[Death by hypothermia. Are there any new diagnostic aspects? (author's transl)].

The report concerns seven cases of death by undercooling which have been investigated this year. The hemorrhaging of muscles in the core of the body (m. iliopsoas) as described by Dirnhofer and Sigrist was found once, this supposedly being a "relatively specific vital sign". In every case it was possible to detect punctiform hemorrhaging of the gastric mucous membrane which according to Unterhofer is decisive when diagnosing death by hypothermia. Furthermore, it was always possible to detect higher acetone values, especially in the urine. This finding could possibly be significant for the diagnosis (death by undercooling). The acetone value is simply a secondary finding when the amount of alcohol is determined by gas chromatography.

Adult↗
PubMed2005

Skeletal muscle metastasis secondary to cancer--a report of seven cases.

Cancer metastasis to the skeletal muscle is very rare. In this report, we describe 7 cases (6 males, 1 female, age 55-76, mean 66 y.o.) with unusual presentation of cancer metastasis to the skeletal muscle, illustrating the principal clinical, radiographic and histologic features. The primary tumors were lung cancer in 4 cases (3 adenocarcinomas, 1 squamous cell carcinoma) and renal cell carcinoma, esophageal carcinoma, hepatocellular carcinoma in each one. The metastatic sites were the adductors, iliopsoas, rectus femoris, biceps bracii, triceps bracii, deltoid, and paravertebral muscle in each one. The unusual sites of metastases were visualized by CT and/or MRI and confirmed by needle or trocar biopsy. Five patients died in 2 to 24 months with the average of 8 months after initial examination.

Aged↗
PubMed1985

Warfarin-induced iliopsoas hemorrhage with subsequent femoral nerve palsy.

We present the case of a 28-year-old man on chronic warfarin therapy who sustained a minor muscle tear and developed increasing pain and a flexure contracture of the right hip. Surgical exploration revealed an iliopsoas hematoma and femoral nerve entrapment, resulting in a femoral nerve palsy and partial loss of quadriceps functions. Anticoagulant-induced femoral nerve palsy represents the most common form of warfarin-induced peripheral neuropathy; it is characterized by severe pain in the inguinal region, varying degrees of motor and sensory impairment, and flexure contracture of the involved extremity.

Adult↗
PubMed1987

Iliopsoas hypertrophy mimicking acute abdomen in a bodybuilder.

Marked hypertrophy of the psoas muscle in a bodybuilder produced a unilateral extrinsic mass effect upon the medial cecum and adjacent small bowel. The patient had presented with right lower quadrant pain and leukocytosis. Routine contrast studies of the abdomen were misleading, but a computed tomogram suggested the correct diagnosis.

Abdomen, Acute↗
PubMed1989

Iliopsoas myofascial dysfunction: a treatable cause of "failed" low back syndrome.

Most patients with low back pain experience loss of spinal and hip extension range of motion. The limitation appears to involve significant iliopsoas myofascial dysfunction manifested in tenderness, as shown by deep abdominal palpation of the psoas muscle, hip flexor contracture, pain elicited by the stretch maneuver of the spine and hip, and relative weakness of the psoas muscle when tested manually. These signs assisted in identifying the source of low back pain in six patients who had failed to respond to prior treatment. Therapy consisted of iliopsoas trigger point treatment using a dry needling technique, followed by self-administered postisometric relaxation exercise of the iliopsoas. In all cases, marked improvement of hip and spine extension, dramatic reduction of pain, and return to normal activity resulted. Given the low risk-to-benefit ratio, trigger point treatment is indicated in "failed back syndrome" and chronic low back pain after conservative therapy or surgery have been tried without success.

Abdominal Muscles↗
PubMed2005

Retrospective review of L3 myelomeningocele in three age groups: should posterolateral iliopsoas transfer still be indicated to stabilize the hip?

The data from 58 hips in 29 myelodysplastic children with L3 paralysis has been reviewed retrospectively. Posterolateral transfer of the iliopsoas (Sharrard technique) was performed on all hips to correct muscle imbalance between 1975 and 1992. The average length of follow-up was 21 years. Preoperatively, 58.6% of the hips were either subluxated or dislocated (these were surgically reduced at the same stage). Radiological assessment revealed that 91.4% of the hips were stable at preschool age and 84.5% in adolescence. Of the patients 86% were functional walkers at preschool age and 75.8% in adolescence. Downward transitions in seven patients were related to the presence of scoliosis, spasticity and obesity. All patients who were community walkers in adolescence maintained their function in adult life at the time of the review. We conclude that the procedure has value in obtaining hip stability and walking ability in carefully selected patients with myelomeningocele.

Adolescent↗
PubMed1979

Gray scale ultrasound: evaluation of iliopsoas hematomas in hemophiliacs.

Because of its insidious nature, intramuscular bleeding, in contrast to hemarthrosis, is missed or belatedly recognized in hemophiliacs. Sixteen patients with suspected iliopsoas bleeding were studied by gray scale ultrasonography. In 12 patients it was possible to confirm the diagnosis of iliopsoas hematoma because of enlargement and rounding of the psoas muscle.

Adolescent↗