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PubMed1994

[Femoral neuropathy due to a spontaneous hematoma of the iliopsoas muscle during therapy with heparin-calcium].

With increased use of anticoagulant agents, femoral neuropathy subsequent to spontaneous hemorrhage within the ileo-psoas muscle has become a serious and more frequent clinical problem. The authors describe one case of femoral neuropathy from iliac muscle hematoma during heparin administration. The successful surgical treatment by decompression and drainage is reported. The anatomical and CT scanning features with the suspected pathogenesis are emphasized, as well as the role of early diagnosis in the assessment of prognosis and for successful operative decompression.

Aged↗
PubMed2003

[Iliopsoas abscess accompanied by epidural abscess--a case report].

A 55-year-old man was admitted to a hospital with pain of the low back as well as the left leg, and fever. He was suspected of suffering from the lumbar disc herniation because of the presence of Lasegue's sign on the first physical examination. Abdominal computed tomography, however, revealed the swelling of the left iliopsoas muscle. Iliopsoas abscess accompanied epidural abscess was confirmed by subsequent magnetic resonance imaging (MRI). Antibiotic therapy was started for the successive 8 days. The fever resolved, but the pain persisted. The abscess extending from the iliopsoas muscle to the epidural space was still seen on the MRI 20 days after the completion of the antibiotic therapy, and he still complained of the pain of his low back and left leg. Therefore, we conducted epidural puncture under fluoroscopic guidance. Approximately 3 ml of pus was aspirated from the epidural space. Then, his complains decreased remarkably. Iliopsoas abscess should be taken into account in case of a patient with pain on the low back and leg and also inflammatory signs such as fever and leucocytosis.

Anti-Bacterial Agents↗
PubMed2001

[The groin pain syndrome].

Groin pain is defined as tendon enthesitis of adductor longus muscle and/or abdominal muscles that may lead to degenerative arthropathy of pubic symphises in an advanced stage. Pubic region is a point where kinematic forces cross. The balance between the adductor and abdominal muscles is of great importance, as well as the elasticity of pubic symphises which enables movement of up to 2 mm and rotation of up to 3 degrees. The weakness of the abdominal muscle wall, known as the sportsman's hernia, is the most common cause of painful groin. Groin pain is the most common in soccer players (6.24% in Croatia). Most authors believe that the main cause of groin pain is the adductor muscle overload. When active, sportsmen start to feel a dull pain in the groin region. The adductor test is of great importance for physical examination; the patient should be lying supine with his hips abducted and flexed at 80 degrees. The test is positive if the patient, while attempting to pull his/her legs against pressing in the opposite direction, feels a sharp pain in the groins. The treatment of groin pain is complex and individual, as its causes may vary from patient to patient. Gradual physical therapy combined with pharmacotherapy should be effective in most cases. The latter includes nonsteroid anti-inflammatory drugs and muscle relaxants. A physical therapy programme usually involves stretching and strengthening of adductor muscles, abdominal wall muscles, iliopsoas muscle, quadriceps, and hamstrings. In case that physical therapy and pharmacotherapy fail, surgery is needed, depending on the cause.

Athletic Injuries↗
PubMed2003

Muscle strength and walking ability after laparoscopic hernioplasty versus conventional repair.

PURPOSE: We examined muscle strength and walking ability after hernia repair to compare the effects of laparoscopic hernioplasty and conventional repair. METHODS: Twenty-seven patients with primary inguinal hernias were randomly divided into two groups according to the surgical procedure: 15 patients were treated with laparoscopic hernioplasty and 12 with conventional repair. Two types of muscle testing around the inguinal region, one by manual examination and one using a musculator, were done preoperatively and 1 week postoperatively. Walking exercise tests were performed at the same time as muscle testing. RESULTS: Manual examination showed that the postoperative muscle strength of the iliopsoas muscle was decreased in six patients from the conventional repair group, but not in any of those from the laparoscopic hernioplasty group. The musculator showed decreased strength of the iliopsoas muscle after conventional repair, but not after laparoscopic hernioplasty. The walking exercise test showed that conventional hernia repair influenced walking. CONCLUSION: A decline in muscle strength of the iliopsoas muscle and walking ability was evident after conventional repair, but not after laparoscopic hernioplasty. Thus, laparoscopic hernioplasty is superior to conventional repair from the perspective of muscle testing and walking ability.

Adult↗
PubMed2002

Post-mortem redistribution of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") in the rabbit. Part I: experimental approach after in vivo intravenous infusion.

Post-mortem redistribution is known to influence blood and tissue levels of various drugs. An animal model was used in an attempt to elucidate this problem for the amphetamine analogue, 3,4-methylenedioxymethamphetamine (MDMA). Rabbits received 1 mg/kg MDMA intravenously (iv) and were killed 2 h later in order to simulate the state of complete distribution in the body. MDMA and 3,4-methylenedioxyamphetamine (MDA) concentrations were determined in blood, urine, bile, vitreous humour, and various tissues (eye globe walls, brain, cardiac muscle, lungs, liver, kidneys, iliopsoas muscle and adipose tissue) using a high pressure liquid chromatographic (HPLC) procedure with fluorescence detection. In the first group (control group, sampling immediately post mortem) considerable MDMA concentrations were found in the brain and both lungs. In addition, our data indicate the elimination of MDMA by hepatic biotransformation and excretion via the bile. When the animals were preserved either 24 or 72 h post mortem (second group), an increase of MDMA and MDA levels in the liver and the eye globe walls was noticed. In the lungs, on the other hand, they tended to decline as a function of increasing post-mortem interval. MDMA levels in cardiac and iliopsoas muscle were fairly comparable and remained stable up to 72 h after death. In the third group, ligation of the large vessels around the heart took place immediately post mortem, but significant differences in blood and tissue MDMA concentrations between rabbits of group 2 and 3 could not be demonstrated. We therefore conclude that post-mortem redistribution of MDMA at the cellular level (viz. by pure diffusion gradient from higher to lower concentrations) is more important than its redistribution via the vascular pathway. Finally, MDA levels were relatively low in all samples, thus indicating that this is not a major metabolite in the rabbit, at least within the first 2 h after administration.

Animals↗
PubMed1999

Estimation of age at death based on quantitation of the 4977-bp deletion of human mitochondrial DNA in skeletal muscle.

The 4977-bp deletion in human mitochondrial DNA (mtDNA) is known to accumulate in various tissues with age. Since this deletion in mtDNA correlates closest with age in muscle tissue, iliopsoas muscle tissue was taken at autopsy from 50 persons aged 24-97 years to determine whether age at death can be estimated based on the amount of the 4977-bp deletion in skeletal muscle. Total DNA (nuclear and mtDNA) was extracted from 100 mg tissue and the 4977-bp deletion quantified using a kinetic polymerase chain reaction (PCR) followed by visualization of the products on silver stained polyacrylamide gels. The amount of the 4977-bp deletion of mtDNA ranged from 0.00049% to 0.14% depending on age, with a correlation coefficient of r = 0.83 (P = 0.0001). In forensic practice this method can aid in the estimation of age at death with a relatively wide confidence interval, thus enabling a discrimination between young and elderly persons in the identification of human remains based solely on skeletal muscle.

Acrylic Resins↗
PubMed2003

The relationship between muscle cross-sectional area and strength in various isokinetic movements among soccer players.

The aim of the present study was to examine the relationships between muscle cross-sectional area (CSA) and muscular strength in terms of knee extension and flexion, hip extension and flexion, and hip abduction and adduction among well-trained soccer players. Fourteen university soccer players participated in the study, who had previously been divided into two groups based on ability (Group A: above-average ability; Group B: average ability). Maximal isokinetic and concentric muscular strength was measured in knee extension/flexion, hip extension/flexion and hip abduction/adduction using an isokinetic dynamometer at 1.57 and 4.19 rad x s(-1) (3.14 rad x s(-1)) in both the dominant and non-dominant leg. The CSAs of the thigh, gluteus muscles and iliopsoas muscles were calculated based on magnetic resonance imaging. There was no significant difference between the two groups in muscle CSA and isokinetic strength. Although there were some statistically significant differences between the dominant and non-dominant leg in terms of CSA and strength (P < 0.05-0.01), these were small and negligible. Apart from a non-significant relationship between the CSAs of the adductor muscles and hip adductor strength (r < 0.26, N.S.), the CSA of the other muscle groups correlated with maximal isokinetic strength (r = 0.38-0.64, P < 0.05). These results suggest that no difference in muscle characteristics (in terms of muscle CSA and strength) was apparent among well-trained soccer players, even between the dominant and non-dominant leg. There is also a case that the anatomical function of a single (or group of) muscle(s) may not be reflected by the strength-CSA relationship depending on the movements (such as hip adduction-adductor muscle CSA). Thus, further studies are required to develop methods to assess neuromuscular function in relation to muscle morphology among soccer players.

Adult↗
PubMedDate not supplied

The superiority of magnetic resonance imaging in differentiating the cause of hip pain in endurance athletes.

The accuracy of magnetic resonance imaging of the hip was prospectively evaluated in 19 military subjects engaged in endurance training. These patients had hip pain, negative radiographs, and radionuclide bone scans consistent with femoral neck stress fracture. Twenty-two hips were identified as positive for femoral neck stress fracture by bone scan. Each patient underwent magnetic resonance imaging and 6-week follow-up plain radiographs of the hips. Magnetic resonance imaging studies differentiated femoral neck stress fractures from a synovial pit, iliopsoas muscle tear, iliopsoas tendinitis, obturator externus tendinitis, avascular necrosis of the femoral head, and a unicameral bone cyst. The follow-up radiographs were used to verify the diagnosis of stress fracture. The radiographs showed healing callus in patients with stress fractures. Patients with diagnoses other than stress fractures had no changes on follow-up radiographs. Magnetic resonance imaging studies were as sensitive and much more specific than bone scan in determining the cause of hip pain. Radionuclide bone scan had an accuracy of 68% for femoral neck stress fractures with 32% false-positive results; MRI was 100% accurate. Magnetic resonance imaging proved to be superior to radionuclide bone scanning in providing an early and accurate diagnostic tool that aided in the differential diagnosis of hip pain in the young endurance athlete.

Adolescent↗
PubMed1985

Antihypertensive effect of riboflavin analogues in spontaneously hypertensive rats.

Our study was designed to use the antimineralocorticoid property of the riboflavin analogue 7,8-dimethyl-10-(3-chlorobenzyl)isoalloxazine (CBI) to investigate the involvement of mineralocorticoids in the hypertension of the Kyoto strain of the spontaneously hypertensive rat (SHR) and Dahl salt-sensitive (S) rat. Wistar Kyoto (WKY) mildly hypertensive rats were used as controls. The administration of the riboflavin antagonist CBI at 5.0 mg/kg body weight twice weekly for 7 weeks lowered the systolic blood pressure (SBP) of the unanesthetized SHR from 188 +/- 7 mm Hg to 148 +/- 2 mm Hg (P less than 0.05). This was concurrent with a 36% and 11% decrease in iliopsoas muscle Na+ concentration and water content, respectively. The simultaneous administration of CBI and hydrochlorothiazide (HCTZ) reduced the SBP to 126 +/- 4 mm Hg (P less than 0.05). There was a profound suppressive effect of CBI on the secondary hyperaldosteronism generated by HCTZ (17.6 +/- 4.3 vs. 50.4 +/- 7.2 ng/dl, P less than 0.05), which was also reflected in the iliopsoas muscle K+ concentration. The effects of CBI on the SBP and iliopsoas muscle Na+ and K+ concentrations of age-matched WKY mildly hypertensive control rats were qualitatively similar to the effects on the SHR. In contrast to the SHR and the WKY rats, the administration of CBI for 8 weeks at 5.0 mg/kg body weight twice weekly to the Dahl S rats did not reduce their mean SBP (205 +/- 5 vs. 200 +/- 4 mm Hg, not significant). CBI treatment did not significantly decrease iliopsoas muscle Na+ concentration or water content.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMed2004

Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study.

BACKGROUND: Groin pain is a diagnostic and therapeutic challenge to sports medicine. The literature provides no consensus on definitions of or diagnostic criteria for groin pain in athletes. To compare the results of research and treatments, the methods used to diagnose and evaluate the degree of groin pain must be clearly defined and reproducible. OBJECTIVES: To describe clinical examination techniques for groin pain in athletes and evaluate the intraobserver and interobserver reliability of these. METHODS: Eighteen athletes, nine with sports related groin pain and nine without groin pain, were examined by two doctors and two physiotherapists. The examiners were trained in the examination techniques before the study. The examiners were blinded to the symptoms and identity of the subjects. The subjects were examined twice by each examiner in random order. The examinations included evaluation of adductor muscle related pain and strength, iliopsoas muscle related pain, strength, and flexibility, abdominal muscle related pain, and strength and pain at the symphysis joint. Kappa statistics and percentage of agreement were used to evaluate the data. RESULTS: Overall, the kappa values and percentage of agreement were in accordance and showed good reliability of the examinations. The kappa values for the intraobserver agreement were above 0.60 in 11 of 14 tests, and those for the interobserver agreement of the pain tests were above 0.60 in eight of 10 tests. The only test without acceptable interobserver reliability was the strength test for iliopsoas muscle. CONCLUSION: All but one of the tests investigated were reproducible and subject only to limited intraobserver and interobserver variation.

Adult↗
PubMed1997

Anatomical course of the lateral femoral cutaneous nerve and its susceptibility to compression and injury.

The anatomy of the lateral femoral cutaneous nerve was investigated through dissection of 52 human anatomic specimens. The variability of its course and locations as it exists the pelvis is described and related to soft-tissue and bony landmarks. Five different types are identified: type A, posterior to the anterior superior iliac spine, across the iliac crest (4 percent); type B, anterior to the anterior superior iliac spine and superficial to the origin of the sartorius muscle but within the substance of the inguinal ligament (27 percent); type C, medial to the anterior superior iliac spine, ensheathed in the tendinous origin of the sartorius muscle (23 percent); type D, medial to the origin of the sartorius muscle located in an interval between the tendon of the sartorius muscle and thick fascia of the iliopsoas muscle deep to the inguinal ligament (26 percent); and type E, most medial and embedded in loose connective tissue, deep to the inguinal ligament, overlying the thin fascia of the iliopsoas muscle, and contributing the femoral branch of the genitofemoral nerve (20 percent). The results of this study suggest that the lateral femoral cutaneous nerve is most susceptible to mechanical trauma when the nerve is type A, B, or C.

Humans↗
PubMed1982

Teardrop bladder: additional considerations.

Nine cases of teardrop bladder (TDB) seen at excretory urography are presented. In some of these patients, the iliopsoas muscles were at the upper limit of normal in size, and additional evaluation of the perivesical structures with computed tomography (CT) was necessary. CT demonstrated only hypertrophied muscles with or without perivesical fat. The psoas muscles and pelvic width were measured in 8 patients and compared with the measurements of a control group of males without TDB. Patients with TDB had large iliopsoas muscles and narrow pelves compared with the control group. The psoas muscle width/pelvic width ratio was significantly greater (p less than 0.0005) in patients with TDB than in the control group, with values of 1.04 +/- 0.05 and 0.82 +/- 0.09, respectively. It is concluded that TDB is a not uncommon normal variant in black males. Both iliopsoas muscle hypertrophy and a narrow pelvis are factors that predispose a patient to TDB.

Adult↗