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PubMedDate not supplied

Technique for iliopsoas ultrasound-guided active electromyography-directed botulinum a toxin injection in cerebral palsy.

Symptomatic hip flexion deformity secondary to iliopsoas spasticity may interfere with gait, impair sitting balance, or contribute to hip subluxation or dislocation. A nonsurgical, minimally invasive technique to ameliorate iliopsoas spasticity is presented. The technique uses intramuscular injections of botulinum A toxin to provide selective neuromuscular blockade of the iliacus or psoas muscles or both. Because of the anatomic location of the target muscles, this technique uses ultrasound guidance for needle placement. Active electromyographic stimulation is used to verify the needle position adjacent to active myoneural interfaces. The authors' experience to date includes the treatment of 28 patients (53 hips). Use of this technique has resulted in improved hip range of motion. No intraoperative or postoperative adverse events or complications have been observed.

Botulinum Toxins, Type A↗
PubMed1981

Independently controlled EMG responses in treadmill locomotion by cats.

Cats were trained to walk and trot on a motor-driven treadmill such that mean kinematic timings were highly uniform. Evidence was sought that variations in electromyographic activity in individual muscles was due to separate sources of control. EMGs were recorded on magnetic tape from a knee extensor, vastus lateralis (VL), and a hip flexor, iliopsoas (IP). At the same time, the cat's movements were recorded on 16 mm cine film at 100 frames per sec. In accordance with previous reports, VL showed one long main burst during the stance (down) portion of the step cycle. However, there were two onset times. A late swing (foot up) component began a few msec before touchdown in every stride in every cat. In contrast, in some cats an earlier burst, that was not completely continuous with the main burst, began 50-100 msec before touchdown and was present in most but not all individual strides. In a few animals there was also an occasional burst in mid-swing. The stance burst itself was further subdivided into multiple peaks that presumably were at least partly reflexive responses to pressure from the belt. The flexor, IP, also showed multiple peaks in its long main burst and other activity whose presence varied from cat to cat. It was concluded that the independence of control for many EMG components during locomotion requires a behavioral analysis of reflexes and conditioned responses to determine the origin of each kind of activity.

Animals↗
PubMed1978

The adductor transfer in the high-risk hip in myelodysplasia: a preliminary report.

Hip instability occurs in meningomyelocele patients with lumbar level paralysis because of muscle imbalance. Transferring the hip adductor origins to the ischium can be used as the primary procedure to restore muscle balance and prevent hip instability in myelodysplasia patients if performed by the age of one year. Twelve lumbar meningomyelocele patients underwent bilateral adductor transfers. Secondary procedures, such as iliopsoas release or transfer or varus derotation osteotomy, were done in 14 hips. Ten hips needed no further surgery. Twenty of 24 hips were clinically and roentgenographically stable and showed roentgenographic evidence of improving hip development. Instability was associated with scoliosis, congenital dislocation, and age greater than one year at the time of the transfer.

Child, Preschool↗
PubMed2001

Groin injuries in athletes.

Groin injuries comprise 2 to 5 percent of all sports injuries. Early diagnosis and proper treatment are important to prevent these injuries from becoming chronic and potentially career-limiting. Adductor strains and osteitis pubis are the most common musculoskeletal causes of groin pain in athletes. These two conditions are often difficult to distinguish. Other etiologies of groin pain include sports hernia, groin disruption, iliopsoas bursitis, stress fractures, avulsion fractures, nerve compression and snapping hip syndrome.

Abdominal Muscles↗
PubMed2005

Pyomyositis. A literature review.

Pyomyositis is a primary bacterial infection of the skeletal muscles. It is known as tropical myositis as most cases have been reported in patients living in tropical areas and, until recently, it was considered unusual in the temperate zone. The condition is usually diagnosed late, and for this reason it is followed by an increased morbidity and sometimes a significant mortality rate. A review of the literature indicates a possibly rising incidence in non-tropical areas. This condition should be considered in patients with muscle pain, fever, leucocytosis, elevated ESR and CRP, in tropical and non-tropical countries, in previously healthy patients as well as in patients suffering other health problems, particularly HIV infection. An MRI investigation should be performed early as it is the imaging technique of choice during the first stage of the disease. A case of a primary iliopsoas pyomyositis diagnosed during the initial stage using MRI is presented as an illustration.

Adult↗
PubMed1981

Function after removal of various hip and thigh muscles for extirpation of tumors.

Forty-six patients who had undergone excision of one or more well defined hip and/or thigh muscles because of a soft-tissue tumor or a tumoriform lesion were investigated with respect to the function of the operated limb and the isometric and isokinetic strength of the affected motion or motions, relative to the non-operated side (percentage). Hip flexion: Loss of the iliopsoas caused slight impairment of function. The flexion strength decreased with increasing flexion of the hip joint. Loss of the rectus femoris reduced the isometric strength by 37 and the isokinetic strength by 17 per cent. Hip abduction: The strength reduction was only about 50 per cent and the impairment of function only slight or moderate even in patients with extensive loss of abductor muscles. Hip adduction: Removal of all three prime adductors (longus, brevis, magnus) caused a strength reduction of about 70 per cent but the impairment of function was only slight or moderate. Hip extension: Loss of the gluteus maximus caused only a small strength reduction and no impairment or only slight impairment of function. Significant strength reduction was only seen when all hamstrings had been removed. Knee extension: Loss of one, two, and three of the quadriceps muscles reduced the isometric strength by 22, 33, and 55 per cent, respectively. The isokinetic strength was reduced somewhat more. The strength reduction usually had to exceed 50 per cent to cause more than slight impairment of function. Knee flexion: Loss of the semitendinosus, the biceps femoris, and all the hamstrings reduced the isometric strength by 24, 28, and 67 per cent, respectively. The isokinetic strength was reduced somewhat less. Loss of one of the hamstrings usually caused no impairment of function whereas loss of all three resulted in moderate impairment of function.

Adolescent↗
PubMed1986

Postural responses in the cat to unexpected rotations of the supporting surface: evidence for a centrally generated synergic organization.

Postural reactions to disruptions of stance are rapid and automatic in both quadrupeds and bipeds. Current evidence suggests that these postural responses are generated by the central nervous system as patterns involving muscle synergies. This study attempted to test this hypothesis of a centrally generated postural mechanism by determining whether the same postural response could be evoked in the freely-standing cat under two different biomechanical conditions. The present work is an extension of previous experiments in which the stance of cats was perturbed by a horizontal translation of the supporting surface in the anterior and posterior directions (Rushmer et al. 1983). We now tested whether simple rotation of the metacarpo- and metatarsophalangeal (M-P) joints that mimics the digit rotation occurring during platform translation, was sufficient to evoke the translation postural response. The rotational perturbations were biomechanically different from translations in that the rotation did not cause displacement of the centre of mass of the animal, nor did it result in any significant movement about any but the M-P joints. Even so, rotational perturbations did evoke the appropriate translational muscle synergies in all four animals. Both plantar flexion rotation and headward translation activated the posterior hindlimb synergy (which included gluteus medius, semitendinosus and lateral gastrocnemius). Similarly, dorsiflexion rotation and tailward translation both activated the same anterior hindlimb synergy (iliopsoas, vastus lateralis and tibialis anterior) together with the forelimb synergy The postural responses elicited by rotational perturbations were biomechanically inappropriate, and caused the animal to displace its own centre of mass away from the stable, control position.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Evaluation of iliopsoas compartment disorders by computed tomography.

BACKGROUND: Iliopsoas compartment lesion frequently goes undiagnosed at clinical presentation. Therefore, even delayed diagnosis may depend on radiographic techniques. Computed tomography (CT) can play an important role in the identification and localization of these lesions. This report concerns the experience of using CT to evaluate the iliopsoas compartment disorder. METHODS: Retrospective review of CT scans for 42 patients who had abnormalities of the iliopsoas compartment revealed that inflammation was responsible in 20, hemorrhage in 8, and tumor in 14 patients. Diagnoses were proven by surgery or biopsy/aspiration in all cases except in five cases whose CT findings correlated with their clinical pictures. A comparison was made among the surgical data, the CT and plain abdominal films. In addition, a comparative evaluation of CT features was also made. RESULTS: By using a hypodense area for the diagnosis of psoas abscess, the sensitivity, specificity and accuracy of CT were 100%, 77%, and 88%, respectively. By using a diffuse involvement of the entire muscle for the diagnosis of hemorrhage, the sensitivity, specificity and accuracy of CT were 63%, 62%, and 62% respectively. By using a bone destruction for the diagnosis of tumors, the sensitivity, specificity and accuracy of CT were 79%, 39%, and 69%, respectively. Evaluation of the iliopsoas compartment lesions was 91% sensitive by CT and 40% sensitive by plain X-ray film. CONCLUSIONS: It is difficult to differentiate iliopsoas abscesses, hematomas and neoplasms without knowing the clinical history. However, when coupled with percutaneous aspiration biopsy, CT has proved to be an effective, rapid means to diagnose and guide the therapy of psoas lesions.

Adult↗