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Iliopsoas muscles: MR study of normal anatomy and disease.

Magnetic resonance (MR) imaging was performed on 15 healthy subjects to define the appearance of the iliopsoas muscle and on 15 patients with iliopsoas disease. Seven patients had tumorous involvement of the muscles, five had inflammatory disease, one had retroperitoneal hemorrhage, one had iliopsoas bursitis, and one had bilateral hypertrophy. MR imaging permitted delineation of the muscles and depiction of the disease condition. Transverse MR images alone almost always provided the necessary data to determine the origin and extent of disease. Sagittal images were occasionally useful in defining the extension of disease into the spine. T1-weighted images provided optimal contrast between the muscles and adjacent tissues, while T2-weighted images were more useful for depicting disease within the muscles themselves.

Abscess↗

[Usefulness of CT in the evaluation of hematoma of the iliopsoas muscle in hemophiliacs].

Four iliopsoas hematomas in hemophiliacs are reported, evaluating the diagnostic role of CT. The specificity of the method is stressed in showing the morphological and densitometric patterns, which allow to localize the hematoma, to state the originating structures, and to follow its evolution. Comparing the obtained results to those found in literature, the authors suggest the use of CT in any hemophiliac in which a retroperitoneal hematoma is suspected.

Adolescent↗

[Impingement of the iliopsoas muscle after revision of a loosened acetabular cup with an acetabular reinforcement ring].

Impingement of the iliopsoas muscle due to a protruding acetabular component is an uncommon cause of pain after total hip arthroplasty. We report the case of a 59 year old female patient who developed groin pain one year after revision arthroplasty and reconstruction of the acteabular defect with an acetabular reinforcement ring due to a loosened cup. THERAPY AND FOLLOW UP: After revision of the right hip via an anterior approach we used bone cement to smooth the anterior edge of the acetabular reconstruction ring and created a smooth rim for the iliopsoas tendon. At follow up 2 years later the patient was satisfied with the result, she complained about very rare recurrent groin pain, without any need for further treatment.

Acetabulum↗

[Post traumatic myositis ossificans of the iliopsoas muscle. Apropos of a case with review of the literature].

A case of traumatic myositis ossificans of the iliopsoas muscle in a 13 year old ballet dancer is presented. A history of multiple minor injuries to the region of the left hip in addition to the radiographic appearance of calcification were indicative of ectopic bone formation. The lesion was explored surgically because of the clinical symptoms of the coexistant femoral hernia as well as to obtain biopsy material to exclude a soft tissue tumor. Histological examination demonstrated the zoning effect of myositis ossificans with patterns varying from a cellular central zone to a peripheral one of fairly well oriented bone. The patient remains symptom-free and no radiographic evidence of recurrence was observed four years postoperatively.

Adolescent↗

EMG activity of the iliopsoas muscle and leg kinetics during the soccer place kick.

The purpose of the study was to develop a method to record intramuscular electromyogram (EMG) from the iliopsoas muscle and to relate this activity to the kinetics during the soccer place kick. Seven skilled soccer players performed 3 maximal velocity place kicks. The kicks were filmed with a high-speed camera (400 Hz) and EMG recordings were obtained from 5 muscles of the kicking leg, including wire electrodes inserted into the m. iliopsoas. The EMG signals were compared to the kinetics of the kicking leg, which were calculated from the digitised film. The results showed hardly any torque reversal about the hip joint before impact. Angular deceleration of the thigh segment did not increase the angular velocity of the shank (work -3.57 to 0.0%). M. iliopsoas was active during the entire kicking motion (average EMG 65.1-100.9%), even in the period when the thigh was decelerating. Wire electrodes can successfully be applied to EMG recordings of fast unloaded movements.

Adult↗

Post-traumatic hematoma of the iliopsoas muscle with femoral nerve entrapment: description of a rare occurrence in a professional cyclist.

The authors describe a case of iliopsoas muscle injury complicated by nerve entrapment, a rare occurrence both in the literature and in clinical experience. The diagnostic procedure excluded the many differential diagnoses possible. The authors prescribed conservative treatment which achieved nearly full recovery of the athlete approximately 6 months after injury.

Adult↗

Primary hemangiosarcoma of the iliopsoas muscle eliciting a peripheral neuropathy.

An eight-year-old, male castrated bullmastiff presented to the Kansas State University Veterinary Medical Teaching Hospital with left hind-limb paralysis. A mass was identified in the left paralumbar soft tissue adjacent to the fourth (L4) to sixth (L6) lumbar vertebrae by magnetic resonance imaging. The iliopsoas muscle contained the mass which was identified as a hemangiosarcoma on histopathological examination. Hemangiosarcoma is rarely reported as a primary tumor arising from muscle vascular endothelium.

Animals↗

Circumscribed myositis ossificans of the iliopsoas muscle. Description of a case followed-up after 1 and 14 years.

The term myositis ossificans (MO) means a pathology characterized by the formation of heterotopic bone tissue within the connective tissue of the muscle. Two clearly differentiated forms of the disease are described: one is generalized and one is localized or circumscribed (CMO). It is the purpose of this study to describe a case of circumscribed myositis ossificans located in the iliopsoas muscle, clinically by CT scan and followed-up after 1 and 14 years.

Adult↗

Prominent iliopsoas muscles producing a gourd-shaped deformity of the bladder.

Hypertrophied iliopsoas musculature should be considered seriously in the evaluation of young muscular male patients presenting with gourd-shaped bladder deformities. The recognition of this nonpathologic gourd deformity during excretory urography and subsequent confirmation by computerized tomography allow an accurate efficient diagnosis, sparing the patient a needless, more extensive investigation.

Adult↗

Descriptive anatomy of the femoral portion of the iliopsoas muscle. Anatomical basis of anterior snapping of the hip.

Anterior hip snapping is a rare clinical observation. The physiopathological hypothesis currently held is a sudden slip of the iliopsoas tendon over the iliopectineal eminence. For symptomatic cases, a surgical technique is proposed. The aim of this work is to describe the anatomy of the femoral portion of the iliopsoas, which is the target of surgery. We have studied, through dissection of embalmed cadavers, the different components of the musculotendinous complex forming the femoral portion of the muscle and the gliding apparatus associated with it. The psoas major tendon exhibited a characteristic rotation. The iliacus tendon, more lateral, received the most medial iliacus muscular fibers, then fused with the main tendon. The most lateral fibers, starting in particular from the ventral portion of the iliac crest, ended up without any tendon on the anterior surface of the lesser trochanter and in the infratrochanteric region. The most inferior muscular fibers of the iliacus, starting from the arcuate line, joined the principal tendon of the psoas major passing around it by its ventromedial surface. An ilio-infratrochanteric muscular bundle was observed, in a deeper position, under the iliopsoas tendon; it arose from the interspinous incisure and on the anterior inferior iliac spine, ran along the anterolateral edge of the iliacus and inserted without any tendon onto the anterior surface of the lesser trochanter of the femur and in the infratrochanteric area. The iliopectineal bursa was studied on horizontal cross sections of a frozen pelvis and on 5 of the non-frozen preparations after dividing the iliopsoas tendon. The iliopectineal bursa had the shape of a 5 to 6-cm high and 3-cm wide cavity; in its upper part, it was divided into 2 compartments: a medial compartment for the main tendon and a lateral compartment for the accessory tendon.

Female↗

Malignant involvement of the iliopsoas muscle: CT appearances.

Computed tomography has led to an increase in recognition of psoas pathology in general and malignant involvement in particular. A series of 25 cases of malignant involvement of the iliopsoas is presented. The wide spectrum of malignant tumours which can invade the psoas and the diversity of CT appearances are described. In particular, it is shown that involvement is frequently extensive, a feature which has not been previously emphasised.

Humans↗

Importance of the iliopsoas muscle in soft-tissue surgery of hip deformities in cerebral palsy children.

Twenty cerebral palsy patients who had undergone soft-tissue surgery at the hip (adductor tenotomy, medial lengthening of the hamstrings) were compared with a matched group of another 20 patients with a similar age range and findings and with additionally performed iliopsoas release, 2 or more years after surgery. Extension deficits of the hip did not improve with the addition of iliopsoas release. Internal rotation deformities showed equal improvement in both groups; the influence of the iliopsoas procedure was not significant. Adduction deformities, as documented on roentgenograms of the hip, showed significant improvement, however. Postural anomalies were not essentially influenced by iliopsoas release. Hip dislocations and subluxations, as assessed by the CE angles, were positively influenced by additional iliopsoas release; however, more effective improvement was obtained with ischiocrural elongation.

Adolescent↗

Computed tomography of the iliopsoas muscle.

Computed tomography (CT) is an ideal method for the imaging of the psoas muscle. The authors present 13 cases of patients with psoas abnormalities diagnosed by CT. The CT features of the different pathologic entities and comparison of CT with other imaging modalities are discussed.

Abscess↗