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At least 343 records · Page 19Linked to original sources
PubMed2005

Extension of lumbar spine infection into osteoarthritic hip through psoas abscess.

We present a case of pyogenic lumbar discitis and septic hip arthritis, accompanied by a psoas abscess and pyogenic iliopsoas bursitis, for which the correct diagnosis was delayed. The patho-mechanism was speculated to be initial hematogenous infection in the lumbar spine that spread along the psoas muscle as a psoas abscess and then extended into the hip joint via the iliopsoas bursa. For an early correct diagnosis, clinicians should be aware that the lumbar spine and hip joint regions communicate through the psoas muscle space and iliopsoas bursa, making it possible for infection to spread.

Bursitis↗
PubMed2006

The psoas quartus muscle.

We report an unusual finding in an adult male cadaver. During the routine dissection of the posterior abdominal wall as part of an anatomy course at our institution, an anomalous muscle was noted. This muscle originated from the transverse process of the left L3 vertebrae and the medial aspect of the quadratus lumborum. We believe this muscle to represent a variety of the psoas quartus that, to our knowledge, has only been described once before in the extant medical literature. The presence of a psoas quartus muscle may contribute to femoral nerve compression. The clinician may wish to consider this rare muscular anomaly in patients with symptoms of femoral nerve compression in which no other clear etiology is found. Furthermore, clinicians who image the posterior abdominal wall should be aware of this potential anomaly when interpreting the anatomy of this region.

Aged↗
PubMed2002

Composition of psoas major muscle fibers compared among humans, orangutans, and monkeys.

In primate species the m. psoas major, the only muscle simultaneously controlling the spinal column and lower extremity, is expected to reflect morpho-functional adaptation to diversified locomotor behavior. By using histochemical analysis with Sudan black B staining, composition of different types of muscle fibers in the psoas major was compared between 2 Japanese macaques, 2 hamadryas baboons, 2 anubis baboons, 2 orangutans, and 17 humans. The comparison has revealed unique features of this muscle in humans: 1) Type 1 or red fibers are thicker than Type 2 or white fibers in humans but vice versa in nonhumans; 2) among the species examined the number of the muscle fibers per unit cross-sectional area is largest, implying the fibers are thinnest, in humans; 3) frequency of Type 1 fibers is highest in humans, intermediate in monkeys, and lowest in the orangutan, whereas Type 2 fibers show an inverse trend among the species. These results suggest a correspondence in primates between the composition of the psoas major muscle fibers and difference in substrates inhabited as well as in their positional behaviors.

Animals↗
PubMed2002

The function of the psoas major muscle: passive kinetics and morphological studies using donated cadavers.

This study was carried out to analyze the phasic heterogeneity in the function of the psoas major muscle (PMM) depending on the flexion angle at the hip joint. The study design was a passive kinetic experiment using 25 osteoligamentous specimens with the PMM tendon. We measured the flexion angle of the hip joint where the PMM tendon loses contact with the femoral head and pelvic surface. Ten osteoligamentous specimens were used for additional measurements of the tensile force and pressure exerted on the PMM and/or at the bone-tendon interface when the PMM tendon was gently pulled in line with the PMM origin in the supine position. The tension loading the PMM tendon was measured at seven different angled positions of hip joint flexion (0 degrees, 15 degrees, 30 degrees, 45 degrees, 60 degrees, 75 degrees, and 90 degrees ), using a load cell attached to a traction appliance. The pressure was measured at each of eight sites along the long axis of the PMM, using a pressure sensor. The PMM tendon lost contact with the femoral head at angled positions of 14 degrees (average) hip flexion, and lost contact with the iliopectineal eminence at positions of 54 degrees (average). The tension was stronger at angled positions of 0 degrees -30 degrees at the hip joint. The pressure on the femoral head and pelvic surface were stronger at positions of 0 degrees -30 degrees at the hip joint. The pressure on the femoral head was strongest at a hip flexion of 0 degrees. The tensile force markedly decreased at 45 degrees -60 degrees flexion at the hip joint, while the pressure on the femoral head gradually reduced to zero in the same phases. We concluded that the PMM works phasically: (1) as an erector of the lumbar vertebral column, as well as a stabilizer of the femoral head in the acetabulum at 0 degrees -15 degrees flexion at the hip joint; (2) less as a stabilizer, in contrast to maintaining its erector action, at 15 degrees -45 degrees; and (3) as an effective flexor of the lower extremity, at 45 degrees -60 degrees.

Aged↗
PubMed1998

Changes in cross-sectional area of psoas major muscle in unilateral sciatica caused by disc herniation.

STUDY DESIGN: A clinical prospective cohort study of 15 healthy volunteers and 25 patients with unilateral sciatica from single-level disc herniation. OBJECTIVES: To detect any changes in the cross-sectional area of the psoas major muscle in patients with single-level (lateral to mediolateral) disc herniation causing unilateral sciatica. SUMMARY OF BACKGROUND DATA: The exact role of the psoas major muscle in the origin of low back pain and sciatica has not been clarified. METHODS: Fifteen healthy volunteers and 25 patients with unilateral sciatica from single-level disc herniation were subjected to magnetic resonance imaging of the lumbar spine. The cross-section area of the psoas major muscle on either side was recorded, and differences were noted. In patients, the cross-section area of either side was compared with and duration of sciatica was related to changes in the cross-section area. RESULTS: Insignificant variation in the cross-section area of the psoas major was observed in volunteers. In the patient group, significant reduction in the cross-section area of the psoas major was observed at the level and the site of the disc herniation. A significant correlation between cross-section area of the psoas major and ipsilateral continuous sciatica was found. There was no relation between the reduction of the cross-section area and the amount of disc herniation. CONCLUSION: The cross-section area of the psoas major is ipsilaterally decreased in unilateral lumbar disc herniation. The reduction in cross-section area is positively correlated with the duration of continuous sciatica.

Cohort Studies↗
PubMed1990

[Psoas lymph node metastasis in patients with carcinoma of the uterine cervix].

Enlargement of lymph nodes between the psoas muscle and lumbar spine was demonstrated on CT in three of 14 cases having Stage IIb and III uterine cervical carcinoma with iliac or paraaortic lymphadenopathy. In two of these, the adjacent lumbar vertebral body was destroyed. We define psoas lymph nodes to include all lymph nodes located between the psoas muscle and the spine. Psoas lymph nodes may be divided into upper and lower groups: the upper group distributed along the lumbar arteries above in level of L4-L5 and the lower group distributed along the lumbar branches of the iliolumbar arteries below L5. There appears to be paravertebral communication between these two groups. The region of the psoas lymph nodes should be scrutinized in interpretating CT in patients with malignant pelvic tumors which have already spread to iliac or paraaortic lymph nodes. Obliteration of fat plane between psoas muscle and lumbar vertebra is a clue to the presence of enlargement of the psoas lymph nodes on CT. Massive enlargement of psoas lymph nodes may be difficult to distinguish from metastasis to psoas muscle. In such cases, MR imaging would be of help to differentiate these two conditions.

Adult↗
PubMed1988

Regulation of lipoprotein lipase in different rat tissues.

In rats maintained on a fat-free diet, hepatic production of very low density lipoprotein (VLDL) fell by only 18% after 20 hours of fasting (as judged by rates of triglyceride accumulation in plasma following administration of Triton WR1339). Infusion of heparin into fed rats caused a rapid accumulation in plasma of two distinct lipase activities in approximately equal amounts: heparin releasable lipoprotein lipase (HR-LPL) and heparin releasable triglyceride lipase (HR-TGL). Fasting reduced the former by 67%, but the latter by only 20 to 25%. To gain insight into the effects of nutritional status on the interorgan distribution of these enzymes, experiments were designed for the perfusion of liver and heart by standard procedures, and of epididymis, gastrocnemius muscle (red fiber), and psoas muscle (white fiber) by micro techniques. After addition of heparin, perfusates were analyzed for each species of lipase. The objective was to selectively monitor the capillary-bound, physiologically functional lipase without significant contamination by intracellular enzyme. HR-TGL was found only in liver, where it represented the major lipase activity; it was only minimally affected by fasting. In epididymis HR-LPL fell by 85% in fasted animals and, remarkably, rebounded almost to ad libitum fed values after only two hours of refeeding. In both heart and gastrocnemius muscle, directional changes in HR-LPL were exactly reciprocal to those seen in epididymis. By contrast, HR-LPL of psoas muscle was unresponsive to fasting. Qualitatively, the data were in keeping with documented nutritionally-induced shifts in tissue disposal of VLDL-triglycerides.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

[Psoas abscess caused by nephrolithiasis with perirenal abscess complicated with pleural effusion].

Left pleural effusion was found in a 60-year-old woman in whom chest radiography performed during a physical check up revealed no abnormality. Abdominal CT scanning revealed an abscess in the left psoas muscle. The psoas abscess was eliminated temporarily by drainage under ultrasonographic guidance and by the administration of antibiotics, but recurred one month later. A stag-horn renal stone considered to have caused the psoas abscess by formation of a perirenal abscess was eliminated by left nephrectomy. It is suggested tentatively that the psoas abscess might have been the cause of the pleural effusion.

Abscess↗
PubMed1998

[Inguinal tumor as the first manifestation of a pancreatic pseudocyst].

We report a case of pancreatic pseudocyst in alcoholic pancreatitis, that presented as a mass in the inguinal region. The mechanism of this peculiar clinical presentation was the dissemination of the content of the pseudocyst along the psoas muscle. We review the involvement of psoas muscle in pancreatic pathology, giving emphasis to reports of inguinal or thigh masses as initial manifestations.

Adult↗
PubMedDate not supplied

A description of the spread of injectate after psoas compartment block using magnetic resonance imaging.

BACKGROUND AND OBJECTIVES: Magnetic resonance imaging (MRI) provides for excellent visualization of spread of solution after peripheral nerve block. The aim of this observational study was to utilize MRI to describe the distribution of injectate (gadopentetate dimeglumine) administered for continuous psoas compartment block (PCB) performed by use of two approaches (Capdevila and modified Winnie) and to describe the spread of injectate to the lumbar plexus. METHODS: Four volunteers were enrolled in a prospective crossover study. Each volunteer underwent PCB with catheter placement performed by use of Capdevila's approach followed 1 week later by PCB, with catheter placement performed by use of a modified Winnie approach. MRI of injectate distribution was performed after each PCB. RESULTS: The catheter was unable to be inserted in 1 volunteer undergoing Winnie's approach; therefore, 7 sets of MR images were analyzed. In 6 of 7 cases (4 Capdevila and 2 Winnie) spread was primarily within the psoas muscle. Contrast surrounded the L2-3 lumbar branch of the femoral nerve at L4 and cleaved the fascial plane within the psoas muscle and spread cephalad to reach the lumbar nerve roots. In 1 case (Winnie approach) contrast spread between the psoas and quadratus lumborum muscles. Contrast surrounded the femoral and obturator nerves where they lie outside the psoas muscle at L5. CONCLUSION: The most common pattern of injectate spread seen on MRI with both approaches to PCB was spread within the body of the psoas muscle around the lumbar branches (L2-4), with cephalad spread to the lumbar nerve roots. One catheter resulted in injectate between the psoas and quadratus lumborum muscles.

Adult↗
PubMed1998

Conjunctival 'MALToma' with systemic recurrence.

We report the recurrence of a localized conjunctival lymphoma arising in mucosal-associated lymphoid tissue (MALToma) in the psoas muscle, 18 months after initial treatment with radiotherapy. Findings from systemic investigations demonstrated MALToma recurrences in the psoas muscle and the stomach. Ocular adnexal MALTomas typically manifest as localized tumors, which respond well to radiotherapy, but a proportion may recur in typical MALT sites. To our knowledge, this is the first report of a recurrence in the psoas muscle, and the clinical implication is that all patients with ocular adnexal lymphomas need to be followed up for an indefinite period.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Response of the trunk muscles to training assessed by magnetic resonance imaging and muscle strength.

A group of 12 sedentary medical students (1 man and 11 women aged 21-27 years) participated in a strength training programme for the trunk muscles lasting 18 weeks. The maximal isometric flexion and extension forces of the trunk muscles were measured before the training and at 18 weeks by dynamometer. The cross-sectional area of the back muscles, i.e. erector spinae, multifidus and psoas muscles, was measured from magnetic resonance images (spin echo sequence TR/TE 1500/80, slice thickness 10 mm) obtained at the L4-L5 disc level before the training, at 11 and 18 weeks. During training, no significant change in the body mass or body fat content was found. Muscle forces or muscle cross-sectional area were not related to body mass. There was a significant increase in both trunk muscle cross-sectional area (psoas muscle P < 0.001 and back muscles P < 0.01) and trunk muscle forces (flexion and extension forces P < 0.01) during the training but no direct association between the muscle cross-sectional area and strength of the flexors and extensors was detected before or after the training.

Adipose Tissue↗
PubMed1984

Femoral nerve dysfunction after retroperitoneal hemorrhage: pathophysiology revealed by computed tomography.

In three patients receiving anticoagulation therapy who developed retroperitoneal hemorrhage computed tomography (CT) clearly localized the resulting hematoma in each case. Three distinct syndromes are described. A hemorrhage within the iliacus muscle resulted in femoral nerve dysfunction. A large hemorrhage within the iliacus muscle which extended into the psoas muscle produced both femoral and obturator nerve dysfunction. A retroperitoneal hemorrhage extrinsic to both the iliacus and psoas muscles did not produce peripheral nerve dysfunction. The pathophysiology of peripheral nerve dysfunction in retroperitoneal hemorrhage is reviewed in detail.

Adult↗
PubMed1995

The psoas major muscle: a three-dimensional geometric study.

The purpose of this study was to use anatomical data obtained from cadavers, and geometrical scaling data obtained from MRI scans of living subjects, to assess the line of action and mechanical function of the psoas major muscle in three dimensions about each lumbar spine level. In addition, the line of action of the psoas major was documented as a function of lordosis. A total of seven cadavers were dissected from which fibre/tendon architecture was measured, while MRI scans were performed on 15 males to obtain centroid paths and area scales of the muscle over its length. In this way, the curving path of muscle line of action was accommodated together with force and moment predictions that recognized the presence of a tendon at lower lumbar levels (up to L3 in some subjects) significantly increasing the stress. Results confirm that the mechanics of the psoas cannot be adequately represented with a series of straight line vectors from vertebral origins to insertion. Moreover, the mechanical action of the psoas major does not change as a function of lumbar spine lordosis as the muscle path of action changes in accordance with changes in spine posture. Functionally, contrary to claims, the psoas cannot act as a 'derotator' of the spine, does not impose large shear forces on the spine in any posture except at L5-S1, and cannot have major affects to 'control lordosis'. It has the potential to stabilize the lumbar spine with compressive loading and with bilateral activation, to laterally flex it, and can create large anterior shear forces but only at L5-S1.

Adult↗
PubMed1997

Transdiscal lumbar sympathetic block: a new technique for a chemical sympathectomy.

UNLABELLED: Genitofemoral neuritis, which occurs when the neurolytic solution spreads into the psoas muscle, is the most common complication after neurolytic lumbar sympathetic block. We developed a transdiscal approach for neurolytic lumbar sympathetic block to reduce the danger of genitofemoral neuritis by making a sympathectomy without penetration of the psoas muscle, through which the genitofemoral nerve passes. We attempted transdiscal lumbar sympathetic block in 14 patients for whom the last previous lumbar sympathetic block performed by using the conventional paravertebral method was unsuccessful. Under fluoroscopic guidance, the needle was inserted transdiscally at L2-3 and/or L3-4 and was advanced until its tip pierced the anterior longitudinal ligament. Radiography and computed tomography revealed that the injected contrast media spread along the anterolateral surface of the vertebral column without any flow into the psoas muscle. Alcohol was injected successfully in all patients. During the 1-mo follow-up period, no patients had any symptom of genitofemoral neuritis. Thirteen patients who had been suffering from lower extremity pain achieved partial or complete pain relief. One patient with plantar hyperhidrosis achieved persistent anhidrosis. These results suggest that the transdiscal approach can be a technical option for neurolytic lumbar sympathetic block. IMPLICATIONS: Neurolytic lumbar sympathetic block was performed with the needle advanced through the intervertebral disc. With this technique, the risk of genitofemoral neuritis, the most common complication after neurolytic lumbar sympathetic block, was reduced because the needle does not penetrate the psoas muscle, through which the genitofemoral nerve passes.

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↗
PubMedDate not supplied

The role of proteases in experimental glucocorticoid myopathy.

Mature, male, New Zealand white rabbits were treated with the synthetic glucocorticoid betamethasone (0.3 mg/kg body weight/day) for 2 weeks. The glucocorticoid treatment caused a 30% decrease in muscle weight of the type 2 psoas muscle, but had no apparent effect on the type 1 soleus muscle. Cathepsin D activity was elevated twofold in the psoas muscle of treated rabbits, a finding suggesting an active role for lysosomes in mediating muscle breakdown in glucocorticoid-induced myopathy of the rabbit. There was no detectable alkaline serine protease activity in the muscles from either treated or control rabbits. Alkaline protease is localized in mast cells in some species, particularly the rat. Toluidine blue staining for mast cells was absent in rabbit muscles, a finding indicating that this species does not contain these cells. This protease, previously implicated in glucocorticoid myopathy, apparently plays no role in rabbit myopathy. There was no detectable elevation of the Ca-activated protease in muscles from glucocorticoid-treated animals. This finding suggests that if this protease plays a role in muscle degradation, its activity is controlled in vivo by special conditions (such as elevated CA levels, inhibitors, and compartmentalizations).

Animals↗