Search

Background The modified Thomas test (MTT) is commonly used to assess the flexibility of hip musculature, including the iliopsoas, rectus femoris, and tensor fascia latae. This measurement is important to include in a comprehensive musculoskeletal examination. However, existing research shows conflicting results regarding its reliability, particularly due to variations in controlling pelvic tilt during testing, which may lead to inaccurate measurements of hip extension when quantifying the test outcomes. Purpose/Hypothesis This study aimed to evaluate the intra- and inter-rater reliability of the Modified Thomas Test (MTT) in assessing hip flexor length using a goniometer. It was hypothesized that controlling for pelvic tilt would enhance the reliability of these measurements. Study Design Intra- and inter-rater reliability study Methods Sixty-four healthy individuals were recruited to participate in this study. The MTT was performed twice on each leg by both an experienced and a student physical therapist. Blinded goniometric measurements for hip extension range of motion (ROM) in the MTT position were taken with neutral pelvic tilt being enforced via palpation. A double-blind protocol was used where both examiners were unaware of each other's measurements and the goniometer was covered to blind the measuring therapist to the values as well. ROM values were entered into a Microsoft Excel spreadsheet and quantified using SPSS software. Statistical analysis included calculating Intraclass Correlation Coefficients (ICCs) and Standard Errors of Measurement (SEMs) using SPSS software. Results The study included 64 participants (mean age = 23.7 ± 4.34 years). The MTT demonstrated high intra-rater reliability (ICC = 0.911) and inter-rater reliability (ICC = 0.851). The SEMs indicated minimal variability around the mean scores. The average hip extension ROM measured was 5.43± 9.73 degrees. Conclusion These results suggest that the MTT is a reliable tool for assessing hip flexor length in clinical practice, particularly when pelvic tilt is controlled. These results have important implications for accurately testing orthopedic limitations that can contribute to low back, hip, and knee pain. Level of Evidence 3 [ABSTRACT FROM AUTHOR]

Background/Objectives: The iliopsoas muscle plays an essential role in lumbopelvic and hip anterior stability, which is particularly important in the presence of limited osseous acetabular coverage anteriorly as in hip dysplasia and/or hip micro-instability. The purpose of this systematic review is to (1) describe iliopsoas activation levels during common rehabilitation exercises and (2) provide an evidence-based exercise progression for strengthening the iliopsoas based on electromyography (EMG) studies. Methods: In total, 109 healthy adult participants ranging from ages 20 to 40 were included in nine studies. PubMed, CINAHL, and Embase databases were systematically searched for EMG studies of the psoas, iliacus, or combined iliopsoas during specific exercise. The Modified Downs and Black Checklist was used to perform a risk of bias assessment. PROSPERO guidelines were followed. Results: Nine studies were included. Findings suggest that the iliopsoas is increasingly activated in ranges of hip flexion of 30–60°, particularly with leg lowering/raising exercises. Briefly, >60% MVIC activity of the iliopsoas was reported in the active straight leg raise (ASLR) in ranges around 60° of hip flexion, as well as with supine hip flexion and leg lifts. In total, 40–60% MVIC was found in exercises including the mid-range of the ASLR around 45° of hip flexion and lifting a straight trunk while in a hip flexed position. Conclusions: The findings suggest that exercises in increased hip flexion provide greater activation of the iliopsoas compared to exercises where the trunk is moving on the lower extremity. Iliopsoas activation can be incrementally progressed from closed to open kinetic chain exercises, and eventually to the addition of external loads. The proposed exercise program interprets the results and offers immediate translation into clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To assess risk factors of retroperitoneal and lower extremity musculoskeletal bleed in acquired haemophilia (AHA) and perform an objective assessment of disability and influence on survival. Methods: We included 49 patients with AHA from November 2017 to May 2023. The occurrence of any retroperitoneal or/and lower extremities bleeding manifestation was investigated. On clinical follow‐up, we search for compressive femoral neuropathy and quadriceps amyotrophy. The lower extremity functional scale (LEFS) was carried out one year after the last bleeding event in all AHA patients. Results: A 61.2% of patients in our AHA cohort presented with any retroperitoneal and/or lower extremities musculoskeletal manifestation. Those patients had higher percentage of major bleeding EACH2/ISTH criteria (90% vs. 57%, p =.01), needs of blood transfusions (86% vs. 57% of patients, p =.03), and haemostatic by‐pass products (90% vs. 63%, p =.02). Hypertension (HR 2.6, 95% CI 1.1–5.9, p =.02), presence of autoimmune disease (HR 13, 95% CI 1.7–99, p =.01), and inhibitor level > 20 BU (HR 2.6 95% CI 1.0–6.8, p =.04) significantly predicted retroperitoneal/lower extremities clinical manifestations. Most frequent sequelae were quad atrophy (30.6%) and femoral nerve palsy (20.4%). Quad atrophy and LEFS scores under 50 were associated with increased mortality (HR 3, 95% CI 1.1–8.6 and HR 12, 95% CI 3.3–45, respectively). Conclusion: AHA with retroperitoneal/lower extremities bleeding involvement is of greater severity and shows high disability and worst survival outcomes. Quadriceps atrophy and LEFS scale scoring under 50 predicted mortality in our AHA patients. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the functional outcome during follow-up (FU) after endoscopic tenotomy for iliopsoas (IP)-cup impingement and to quantitatively analyze the hip flexion strength. Methods: This was a monocentric, retrospective cohort study of a single surgeon series. Functional assessment was based on the modified Harris score, the Oxford score and the visual analog scale score. Strength was measured with a handheld dynamometer in the sitting and lying position. Results: Thirty-six IP tenotomies for cup impingement were performed between May 2013 and November 2021. Seven (19%) patients were lost to FU. At the time of tenotomy, the mean (standard deviation) age was 62,6 (12,2) and BMI was 26,5 (4,1). The mean FU time after tenotomy to the last FU was 3,6 (0,8) years. All three outcome scores improved from preoperatively to six months postoperatively (p < 0.001). There were no significant change from six months to last FU. The minimal clinically important difference (MCID) of the modified Harris score was set at 25. 20 (69%) patients had values that exceeded the threshold at one month and six months and neutral 19 (65.5%) had values that exceeded the threshold at the last FU. The limp symmetry index concerning hip flexion strength was 63% at 90° and 40% at 30° at the last FU. Conclusion: Most patients significantly improved their outcome scores after endoscopic iliopsoas tenotomy, with results remaining consistently stable over time. Despite a significant loss in hip flexion strength, the majority of patients did not report any impairment of their quality of life. Study design: Level III, Retrospective cohort study. [ABSTRACT FROM AUTHOR]

Abstract Background While extensive research exists on muscle injuries among adult football players, a notable gap persists in studies concerning younger footballers. The aim of the current study is to provide epidemiological data on the characteristics of time-loss muscle injuries in young football players participating in the Italian Under-19 male elite Championship (“Primavera 1”). Results Conducted as a multicentre, prospective, observational cohort study, this research gathered injury data from the 2022-23 season across 14 of the 18 Clubs in the first Italian Under-19 championship. The cohort comprised 391 players with a mean age (± standard deviation) of 18.0 ± 0.4 years. A total of 479 injuries were reported, resulting in 14,231 days of activity lost. Of these, muscle injuries were 209 (44%), accounting for 4,519 (32%) days lost. Overall muscle injuries incidence was 1.82/1000 hours, with a mean injury burden of 39.4 days lost/1000 hours. Almost all muscle injuries (206 out of 209: 98.5%) occurred in hamstrings, quadriceps, adductors, calf and iliopsoas. Hamstrings injuries were the most burdensome (18.8 days lost/1000 hours) accounting for nearly half of all days lost due to muscle injuries. Incidence and burden of adductors injuries (0.25 injuries and 4.1 days lost/1000 hours, respectively) were found to be comparable to calf injuries (0.24 injuries and 4.7 days lost/1000 hours, respectively). Iliopsoas injuries accounted for a noteworthy portion of the total, with an injury incidence of 0.16/1000 hours and a burden of 3.3 days lost/1000 hours. Injuries with myo-tendinous or myo-aponeurotic involvement demonstrated delayed return-to-football compared to those without such involvement (35.6 vs. 18.5 days, p

Background: While extensive research exists on muscle injuries among adult football players, a notable gap persists in studies concerning younger footballers. The aim of the current study is to provide epidemiological data on the characteristics of time-loss muscle injuries in young football players participating in the Italian Under-19 male elite Championship ("Primavera 1"). Results: Conducted as a multicentre, prospective, observational cohort study, this research gathered injury data from the 2022-23 season across 14 of the 18 Clubs in the first Italian Under-19 championship. The cohort comprised 391 players with a mean age (± standard deviation) of 18.0 ± 0.4 years. A total of 479 injuries were reported, resulting in 14,231 days of activity lost. Of these, muscle injuries were 209 (44%), accounting for 4,519 (32%) days lost. Overall muscle injuries incidence was 1.82/1000 hours, with a mean injury burden of 39.4 days lost/1000 hours. Almost all muscle injuries (206 out of 209: 98.5%) occurred in hamstrings, quadriceps, adductors, calf and iliopsoas. Hamstrings injuries were the most burdensome (18.8 days lost/1000 hours) accounting for nearly half of all days lost due to muscle injuries. Incidence and burden of adductors injuries (0.25 injuries and 4.1 days lost/1000 hours, respectively) were found to be comparable to calf injuries (0.24 injuries and 4.7 days lost/1000 hours, respectively). Iliopsoas injuries accounted for a noteworthy portion of the total, with an injury incidence of 0.16/1000 hours and a burden of 3.3 days lost/1000 hours. Injuries with myo-tendinous or myo-aponeurotic involvement demonstrated delayed return-to-football compared to those without such involvement (35.6 vs. 18.5 days, p < 0.0001). Conclusions: The study highlighted a peculiar distribution of non-contact muscle injuries among elite young football players. While hamstring injuries were confirmed as the most burdensome, incidence and burden of adductors and calf injuries were found to be similar. A significant incidence and burden of iliopsoas injuries were observed. These findings suggest potential implementations for targeted injury prevention strategies in the Italian male elite Under-19 football Championship. Key points: • In the Italian male elite Under-19 football Championship, each Club can expect around 15 non-contact muscle injuries during the season (for a team of 25 players) distributed as follows: 6 hamstrings, 3 quadriceps, 2 adductors, 2 calf and 1 iliopsoas muscle injuries. • Hamstrings injury incidence and burden (both in training sessions and during matches), as well as the proportion of reinjuries, were found to be the highest among muscle sites. • Injuries to adductors and calf muscles exhibited comparable values of incidence and burden. • Iliopsoas emerged as a noteworthy site of injury in the current cohort, particularly during training sessions. • Aponeurosis or tendon damage was associated with longer return to football timing, particularly in hamstrings and adductors injuries. [ABSTRACT FROM AUTHOR]

Copyright of Arthroskopie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ischiofemoral injuries are very rare and their importance is underestimated. The ischiofemoral injuries include avulsion fractures of the lesser trochanter and the ischial tuberosity, rupture or injury of the quadratus femoris muscle and rupture or injury of the iliopsoas tendon. As a rule, conservative therapy is carried out, although in individual cases surgical treatment must be considered. As a result of an ischiofemoral injury, ischiofemoral impingement can occur. On the other hand, ischiofemoral impingement can lead to an injury or rupture of the quadratus femoris muscle. [ABSTRACT FROM AUTHOR]

Des lésions du labrum sont retrouvées dans 22 % à 55 % des douleurs coxo-fémorales, mais elles n'en sont que rarement directement responsables, car ces douleurs proviennent surtout des structures adjacentes au labrum, soit intra-articulaires (lésions ostéochondrales), soit périarticulaires (capsule, sur laquelle s'insèrent rectus femoris , gluteus minimus , et iliopsoas). Bien que la suture précoce des déchirures labrales chez de jeunes sportifs puisse induire des soulagements rapides, et pourrait différer la survenue d'une coxarthrose, les micro-instabilités favorisées par les déchirures labrales paraissent bien moins importantes dans la pathogénie des lésions que les dysplasies/dysmorphies sous-jacentes. Les lésions labrales sont en effet presque toujours la conséquence de dysplasies, ou de dysmorphies responsables de conflits fémoro-acétabulaires. La présente revue aborde : (i) les sources des douleurs pouvant être amplifiées par les lésions labrales ; (ii) la difficulté à affirmer une micro-instabilité ; (iii) les moyens de détecter les lésions labrales, tant cliniquement (dont par le test IROP), que sur l'imagerie (IRM, arthroscanner, échographie). La mise en traction des coxo-fémorales ne semble pas majorer la sensibilité de l'échographie pour étudier le labrum. Par contre, l'échographie peut aider à guider le site des infiltrations périarticulaires, à envisager quand un soulagement n'est pas obtenu par une anesthésie intra-articulaire. Certaines douleurs paraissent en effet dues à des déchirures de la partie superficielle de l'épaisse capsule, dans les zones où s'insèrent sur elle le rectus femoris , le gluteus minimus et l'iliopsoas. Des travaux futurs pourraient mieux apprécier les efficacités respectives dans ces cas des réparations labrales, débridements tendineux, sutures capsulaires, ou dénervations focales. Hip labral tears are found in 22‐55% of individuals with hip pain, but labral tears without cysts are usually not responsible for hip pain, which originates mostly from other structures than the torn labrum, like osteochondral, but also tendinous injuries (rectus femoris , gluteus minimus , iliopsoas) or capsulo-ligamentous tears (iliofemoral ligaments, ligament teres). Those lesions are mainly the consequences of underlying unrecognized functional acetabular dysplasia, and/or femoroacetabular impingements. Although the early repair of labral tears in young sportsmen induces a marked and lasting relief, and might delay the onset of osteoarthritis, the microinstability fostered by labral damages seems less important than underlying dysplasias/impingements. This narrative review details recent findings on: i) the various mechanisms of pain associated with labral tears; ii) few evidence for hip microinstability induced by isolated labral tears; iii) how to best detect labral tears, both clinically (including through IROP test) and on imaging (MRI, MRA, computed tomography arthrography, ultrasound). Some authors suggested to use pull-out tests during surgery, but pulling of hips do not seem to increase much diagnostic performances of ultrasounds. Ultrasound-guided intra-articular and peri-articular injections may tell how often hip pain is exclusively induced by peri-capsular injuries secondary to the acetabular dysplasia/femoro-acetabular impingements already responsible for labral tears. Further works could tell whether labral repair, tendinous debridement, plication of capsule, and/or focal denervation, may induce lasting reliefs of pain induced by the chronic contraction of surrounding muscles (rectus femoris , gluteus minimus , psoas), whose deep aponeuroses mix with the superficial fibres of the thick hip capsule. [ABSTRACT FROM AUTHOR]

Background and purpose: The diagnosis of functional neurological disorder should be actively made based on the neurological signs. We described two new complementary signs to diagnose functional weakness of the lower limb, "weak gluteus maximus (weak GM)" and "weak Iliopsoas with normal gluteus maximus (weak iliopsoas with normal GM)," and tested their validity. Methods: The tests comprised Medical Research Council (MRC) examinations of the iliopsoas and GM in the supine position. We retrospectively enrolled patients with functional weakness (FW) or structural weakness (SW) who presented with weakness of either iliopsoas or GM, or both. Weak GM means that the MRC score of GM is 4 or less. Its complementary sign, weak ilopsoas with normal GM, means that the MRC score of ilopsoas is 4 or less, whereas that of GM is 5. Results: Thirty‐one patients with FW and 72 patients with SW were enrolled. The weak GM sign was positive in all 31 patients with FW and in 11 patients with SW, that is, 100% sensitivity and 85% specificity. Therefore, the complementary sign, weak iliopsoas with normal GM, was 100% specific for SW. Discussion: Although 100% should be discounted considering limitations of this study, these signs will likely be helpful in differentiating between FW and SW in the general neurology setting. Downward pressing of the lower limb to the bed in the supine position is interpreted by the patient as an active movement exerted with an effort and might be preferentially impaired in FW. [ABSTRACT FROM AUTHOR]

Iliopsoas tendinopathy (IPT) can cause persistent groin pain and lead to dissatisfaction after total hip arthroplasty (THA). This study aimed to report the characteristics, incidences, risk factors, and treatment outcomes of IPT after THA. We reviewed primary THAs performed at a single institution between January 2012 and May 2018. Clinical and radiographic analyses were performed on 1,602 THAs (1,370 patients). Patient characteristics, component sizes, inclination and anteversion angles, and antero-inferior cup prominence (≥8 millimeters (mm)), were compared between the groups with and without IPT. Changes in teardrop to lesser trochanter distance were measured to estimate changes in leg length and horizontal offset caused by THA. Logistic regression models were used to identify the risk factors for IPT. IPT was identified in 53 hips (3.3%). Patients with IPT had greater leg lengthening (12.3 versus 9.3 mm; P =.001) and higher prevalence of antero-inferior cup prominence (5.7 versus 0.4%; P =.002). There was no significant difference in inclination, anteversion, and horizontal offset change between the two groups. In multivariate analyses, greater leg lengthening, prominent acetabular cup, women, and higher body mass index were associated with IPT. All patients reported improvement in groin pain after arthroscopic tenotomy, while 35.7% with nonoperative management reported improvement (P <.001). Symptomatic IPT occurred in 53 (3.3%) of the 1,602 primary THAs. Our findings suggest that leg lengthening as well as prominent acetabular cup in THAs can be associated with the development of IPT. Arthroscopic tenotomy was effective in relieving groin pain caused by IPT. [ABSTRACT FROM AUTHOR]

الملخص: الخلفية: مرضى كوفيد-19 ذوي الحالات الحرجة لديهم مخاطر أعلى للإصابة بحالات فرط التخثر. في الوقت الحالي، تم إعطاء العديد من مرضى COVID-19 مضادات التخثر أو العلاجات المضادة للصفيحات لتقليل خطر تجلط الدم المنتظم. الورم الدموي في العضلة القطنية هو أحد المضاعفات القاتلة والنادرة لاضطرابات النزيف أو العلاج المضاد للتخثر والذي يتطور أحيانا ليصبح مهما سريريا. الغرض الرئيسي من مراجعة الحالة هذه هو التأكيد على أهمية تشخيص أورام العضلة القطنية الدموية وإمكانية مساهمة مضادات الصفيحات في تطورها. عرض الحالة: نعرض هنا حالة نادر لورم دموي في العضلة القطنية غير رضحي في مريض لا يتناول مضاد للتخثر. المريض رجل يبلغ من العمر 59 عاما، مصاب بمرض السكري من النوع الثاني، ويتناول أدوية سكر الدم عن طريق الفم، بعد 3 أسابيع من الإصابة بكوفيد-19. كان قد بدأ تناول الأسبرين 81 ملغ عن طريق الفم، مرة واحدة يوميا، للوقاية من الأحداث التخثرية المرتبطة بعدوى كوفيد-19، دون استخدام مضادات التخثر ولا أدوية أخرى. قدم المريض إلى قسم الطوارئ، يشتكي من ضعف الطرف الأيمن التدريجي لمدة أسبوعين، وقد تم تأكيد تشخيص الورم الدموي في العضلة القطنية بناءً على الفحص الإشعاعي. الاستنتاجات: ينبغي النظر في إمكانية حدوث ورم دموي في العضلة القطنية في المرضى الذين لا يستخدمون مضادات للتخثر ولا يعانون من اضطرابات تخثر وراثية أو مكتسبة، ويشتكون من ضعف في الأطراف. يجب دراسة الصلة بين استخدام مضادات الصفيحات في مريض كوفيد -19 وتطور نزيف الأنسجة الرخوة (مثل الورم الدموي في العضلة القطنية). Abstract: Background: Critically ill COVID-19 patients have an elevated risk of experiencing hypercoagulable conditions. Currently, many COVID-19 patients have been administered anticoagulation or antiplatelet therapies to lower the risk of systematic thrombosis. Iliopsoas hematoma is a potentially fatal and rare complication of bleeding disorders or anticoagulation therapy which sometimes grows to become clinically significant. The main purpose of this case review is to emphasize the importance of diagnosing iliopsoas hematomas and the possibility of antiplatelet contribution to its development. Case Presentation: We are reporting a rare presentation of non-traumatic iliopsoas hematoma in a non-anticoagulated patient. The patient is a 59-year-old male, with known type-2 diabetes, on oral hypoglycemic medications, 3-weeks post-COVID-19. He had started aspirin 81 mg orally, once daily, to prevent thrombotic events associated with COVID 19 infection, with no anticoagulant use and no other medications. He came in through the ED, presenting with two weeks history of progressive right lower limb weakness in which an iliopsoas hematoma diagnosis was confirmed based on radiological investigation. Conclusion: The possibility of iliopsoas hematoma should be considered in non-anticoagulated patients with no inherited or acquired coagulation disorders presenting with limb weakness. The link between antiplatelet use in a COVID-19 patient and the development of soft tissue bleeding (e.g., iliopsoas hematoma) must be studied further.

We report two cases of traumatic iliopsoas hemorrhage, without hemoperitoneum, initially detected by ultrasound. Flexion hip contracture in the first case and incomplete femoral nerve palsy in the second case alerted the sonographer to the possibility of traumatic iliopsoas hemorrhage. The first case involved a 54-year-old man who complained of progressive right flank pain and difficulty in walking after falling to the ground. The second case involved a 34-year-old man who complained of severe lower back pain and numbness and weakness of the left leg after a motorcycle accident. In both cases, iliopsoas hemorrhage was confirmed on subsequent multidetector computed tomography.

Abstract Background and purpose The diagnosis of functional neurological disorder should be actively made based on the neurological signs. We described two new complementary signs to diagnose functional weakness of the lower limb, “weak gluteus maximus (weak GM)” and “weak Iliopsoas with normal gluteus maximus (weak iliopsoas with normal GM),” and tested their validity. Methods The tests comprised Medical Research Council (MRC) examinations of the iliopsoas and GM in the supine position. We retrospectively enrolled patients with functional weakness (FW) or structural weakness (SW) who presented with weakness of either iliopsoas or GM, or both. Weak GM means that the MRC score of GM is 4 or less. Its complementary sign, weak ilopsoas with normal GM, means that the MRC score of ilopsoas is 4 or less, whereas that of GM is 5. Results Thirty‐one patients with FW and 72 patients with SW were enrolled. The weak GM sign was positive in all 31 patients with FW and in 11 patients with SW, that is, 100% sensitivity and 85% specificity. Therefore, the complementary sign, weak iliopsoas with normal GM, was 100% specific for SW. Discussion Although 100% should be discounted considering limitations of this study, these signs will likely be helpful in differentiating between FW and SW in the general neurology setting. Downward pressing of the lower limb to the bed in the supine position is interpreted by the patient as an active movement exerted with an effort and might be preferentially impaired in FW.

Introduction. Labral tears (LT) can present with hip or groin pain. Investigation of LT is typically with Magnetic Resonance Arthrography (MRA). The injection of contrast for MRA can lead to fluid signal intensity/oedema on fluid sensitive sequences within the iliopsoas muscle and tendon complex masking the diagnosis of iliopsoas tendinopathy, which may present with similar symptoms. The aim of this study was to identify the presence of iliopsoas oedema in young adult patients being investigated for LT. Material and methods. We performed a retrospective search of our radiology system for the word ‘labral tear’ in the reports of patients who had MRI between 2012 to 2018. Patients under the age of 40 years who underwent high resolution dedicated hip MRI were included in our study. From this database, we then used a keyword search ‘strain and (o)edema’ to identify cases of iliopsoas pathology and analysed the results. Results. We identified 1151 consecutive cases of high resolution hip MRI with a suspected labral tear. 503 patients under the age of 40 years were included in our study with the average age of 27 years. Of the 503 patients within our cohort, searching for the word ‘strain’ identified 48 (9.5%) cases. Of these, 26 (5.3%) patients had iliopsoas oedema with a labral tear. 22 (4.4%) patients had iliopsoas oedema without a labral tear. Conclusion. Our study shows that 4.4% of patients undergoing MRA have no labral tears but iliopsoas oedema. Patients should undergo MRI to exclude iliopsoas strains before MRA.

• Iliopsoas hematoma with resultant femoral nerve palsy is a rare phenomenon for which the optimal treatment is unclear. • PubMed, Embase, and Cochrane database review yielded 122 articles containing 174 distinct cases of the syndrome. • 49% of all cases resulted in persistent motor deficit – 34% of those treated surgically and 66% of those treated conservatively. • Disparate data presentation prevented direct statistical comparison of patients treated conservatively versus surgically. • Based upon review, surgical treatment is usually reserved for larger hematomas with progressive or severe neurological symptoms. Iliopsoas hematoma with femoral nerve palsy is a rare phenomenon with no consensus treatment algorithm. The objective of this study was to perform a systematic review of all reported cases of femoral nerve palsy secondary to iliopsoas hematoma to better elucidate it's optimal treatment. Queries of the PubMed, Embase, and Cochrane databases were performed for reports available in English of femoral nerve palsy secondary to iliopsoas, psoas, or iliacus hematoma. 1491 articles were identified. After removal of duplicated publications and review of abstract titles via a majority reviewer consensus, 217 articles remained for consideration. Dedicated review of the remaining articles (including their reference sections) yielded 122 articles representing 174 distinct cases. Clinical data including patient age, sex, medical history, use of pharmacologic anticoagulation, sensory and motor examination at presentation and follow-up, hematoma etiology and location, time to intervention, and type of intervention were collected. Descriptive statistics were generated for each variable. Femoral nerve palsy secondary to iliopsoas hematoma occurred at a mean age of 44.5 years old. A majority of patients (60%) were male, and a majority of hematomas (54%) occurred due to pharmacologic anticoagulation. Most hematomas (57%) were treated conservatively, and almost half (49%) – regardless of treatment modality - resulted in persistent motor deficits at final follow-up. A minority of patients treated surgically (34%) had residual motor deficit at final follow-up, while 66% of those treated medically had resultant motor deficits, although no direct statistical comparison was able to be performed. The disparate available data on iliopsoas hematoma with femoral nerve palsy precludes the completion of a true metanalysis, and therefore any conclusions on an optimal treatment algorithm. Based on review of the literature, small to moderate hematomas are often treated conservatively, while larger hematomas with progressive neurological symptoms are usually managed with a percutaneous decompression or surgery. IV [ABSTRACT FROM AUTHOR]

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report two cases of traumatic iliopsoas hemorrhage, without hemoperitoneum, initially detected by ultrasound. Flexion hip contracture in the first case and incomplete femoral nerve palsy in the second case alerted the sonographer to the possibility of traumatic iliopsoas hemorrhage. The first case involved a 54-year-old man who complained of progressive right flank pain and difficulty in walking after falling to the ground. The second case involved a 34-year-old man who complained of severe lower back pain and numbness and weakness of the left leg after a motorcycle accident. In both cases, iliopsoas hemorrhage was confirmed on subsequent multidetector computed tomography. [ABSTRACT FROM AUTHOR]

Hypaxial muscle abscess is an important differential in dogs presenting for abdominal or back pain, lameness, and nonspecific signs like fever, lethargy, and hyporexia. It can occur concurrently with intrathoracic disease such as pyothorax secondary to migrating vegetal foreign material. Twelve dogs that underwent CT of the lumbar spine or abdomen and had a diagnosed hypaxial abscess on surgical and/or microbiological examination were included in this retrospective, descriptive case series. Computed tomography findings and findings from other imaging modalities employed were described. Eleven dogs were hunting breeds. Clinical signs included lethargy, fever, increased respiratory effort, and abdominal or back pain. Radiography and/or ultrasonography were employed during preliminary work up at clinician discretion and respectively revealed changes consistent with osteomyelitis in the cranial lumbar vertebrae and heterogenous, hypoechoic areas in the hypaxial musculature consistent with abscesses. Computed tomography findings included enlargement of hypaxial muscles with well‐defined fluid attenuating noncontrast enhancing areas with a contrast‐enhancing rim consistent with abscesses, periosteal reaction and lysis of vertebrae, and retroperitoneal effusion. Four of the 12 cases in this series had material identified and removed at surgery. The other eight cases were presumed to be the same disease process based on compatible signalment, imaging findings, and microbiological results. Migrating vegetal foreign bodies are a common problem at the authors' institution. Computed tomography provided expedient, thorough visualization of the relevant hypaxial lesions for diagnostic and surgical planning purposes and also characterized intrathoracic components of this disease. [ABSTRACT FROM AUTHOR]

Case: A 40-year-old man presented with spontaneous, atraumatic right groin pain and inability to bear weight secondary to an isolated avulsion of the right lesser trochanter. Magnetic resonance imaging of the affected hip was suggestive of an infection, and a computed tomography–guided biopsy was remarkable for Mycobacterium tuberculosis , which was successfully managed with antitubercular therapy and activity modification. Conclusion: Although an isolated spontaneous avulsion of the lesser trochanter is typically pathognomonic for malignancy, an infectious etiology, such as tuberculosis, should also be considered in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Musculotendinous deficiencies related to iliopsoas tendinitis and abductor mechanism disruption following total hip arthroplasty (THA) are frequently under diagnosed and can be frustrating to surgeons and devastating to patients with painful THAs with normal appearing radiographs. Current peer-reviewed evidence is presented for diagnosis and treatment options for these two musculotendinous deficiencies. While these musculotendinous deficiencies are treatable, prevention during the primary THA is ideal, and special attention should be taken into consideration for optimized acetabular cup size and position, optimized hip biomechanics, and preservation and protection of the abductor tendon insertion to the greater trochanter. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the immediate effect of kinesio taping (KT) over abdominal muscles with different tensions on the components of the lumbopelvic complex. Materials and Methods: This is a single-blind randomized controlled clinical trial. Participants were 44 healthy male athletes aged 18-30 years with increased anterior pelvic tilt (PT). Three intervention groups underwent 15 minutes of KT over rectus abdominis and external oblique muscles with tensions of 100, 115, and 140%, respectively, and one group was considered as the control group with no KT. The PT and lumbar lordosis angles and iliopsoas and hamstring muscle lengths were measured before and after the KT. Repeated measures ANOVA was used to compare the means in the study groups before and after the intervention. Results: The mean of right and left PT and lumbar lordosis angles in groups with 115 and 140% tensions before and after the intervention were statistically different (P<0.05). Moreover, the mean of right and left PT and lumbar lordosis angles showed a significant difference between the groups after the intervention (P<0.05). There was a significant difference in active and passive hamstring lengths on both sides in the group received KT with 140% tension before and after the intervention (P<0.05). Conclusion: Kinesio taping with high tension on rectus abdominis and external oblique muscles can reduce their PT angle and lumbar lordosis and increase hamstring muscle length in men with increased anterior PT. This issue should be considered in lumbopelvic complex physiotherapy. [ABSTRACT FROM AUTHOR]

Purpose: This cadaveric study aimed at describing the anatomical variations of the iliopsoas complex. Methods: The iliopsoas complex was dissected unilaterally in 28 formalin-embalmed cadavers—13 males and 15 females with a mean age of 85.6 years. The number, courses and widths of the iliacus and psoas major tendons were determined. Patients with previous hip surgery were excluded. The following measurements were taken from the mid-inguinal point: the distance to the point of union of the psoas major and iliacus tendon; and the distance to the most distal insertion of iliopsoas. Results: The presence of single, double and triple tendon insertions of iliopsoas were found in 12, 12 and 4 of the 28 specimens, respectively. When present, double and triple tendons inserted separately onto the lesser trochanter. The average length of the iliopsoas tendon from the mid-inguinal point to the most distal attachment at the lesser trochanter was 122.3 ± 13.0 mm. The iliacus muscle bulk merged with psoas major at an average distance of 24.9 ± 17.9 mm proximal to the mid-inguinal point. In all cases, the lateral-most fibres of iliacus yielded a non-tendinous, muscular insertion on to the anterior surface of the lesser trochanter and the femoral shaft, rather than joining onto the main iliopsoas tendon(s). The average total width of the psoas major tendon decreased with an increasing number of tendons: 14.6 ± 2.2 mm (single tendon), 8.2 ± 3.0 mm (2 tendons present) and 5.9 ± 1.1 mm (3 tendons present) (P < 0.001). Conclusions: The results of this study suggest that multiple tendinous insertions of iliopsoas are present as an anatomical variant in more than 50% of the population. The non-tendinous muscular insertion of the iliopsoas on to the anterior surface of the lesser trochanter and femoral shaft found represents a novel anatomical variant not previously described. Level of evidence: Level V [ABSTRACT FROM AUTHOR]

Objective: Hip pain is common in patients of advanced age and has a very broad differential. Of the potential aetiologies, iliopsoas tendon ruptures are rare. Consequently, there is a paucity of literature on iliopsoas rupture in the older adult population, and its rarity can lead to a delay in its diagnosis. When iliopsoas ruptures do occur, they are typically secondary to trauma; however, they can occur spontaneously. Iliopsoas injuries can be disabling, but they respond well to conservative management. We report here a case of a 70-year-old woman who presented to an unaffiliated emergency department with left anterior hip pain 2 weeks after a fall from standing height. Results: Initial X-ray and computed tomography were negative for fracture, and the patient was discharged with home health physical therapy. Her symptoms persisted. At a subsequent emergency department visit several weeks later, magnetic resonance imaging revealed a complete left iliopsoas tendon rupture with retraction. She was treated conservatively and made a complete recovery after physical therapy. Discussion: This paper reviews the literature related to iliopsoas injuries, highlights the importance of iliopsoas tendon injuries among the differential for acute hip pain, and provides management recommendations for this rare, but probably underdiagnosed, injury. This treatable condition warrants further attention, as delay in diagnosis can prolong morbidity. LAY ABSTRACT Hip pain is common in the elderly population and has many causes. Of the potential sources of hip pain, a complete tear of the iliopsoas, or hip flexor, tendon is rare. When iliopsoas tears do occur, it is typically after trauma, such as a fall. However, tears can happen spontaneously. Diagnosis is best made using magnetic resonance imaging (MRI), but can be made with ultrasound. These injuries can be disabling, but respond well to conservative management consisting of rest and pain management principles, followed by physical therapy active rehabilitation. This paper reviews the literature on iliopsoas tears, provides management recommendations for this rare, but probably underdiagnosed, injury, and reports a case of a 70-year-old woman who experienced a complete iliopsoas tear after a fall from standing height. The diagnosis was missed on initial evaluation, and was subsequently made using MRI. The patient made a full recovery after conservative management.

Introduction: This study aimed to investigate the immediate effect of kinesio taping (KT) over abdominal muscles with different tensions on the components of the lumbopelvic complex. Materials and Methods: This is a single-blind randomized controlled clinical trial. Participants were 44 healthy male athletes aged 18-30 years with increased anterior pelvic tilt (PT). Three intervention groups underwent 15 minutes of KT over rectus abdominis and external oblique muscles with tensions of 100, 115, and 140%, respectively, and one group was considered as the control group with no KT. The PT and lumbar lordosis angles and iliopsoas and hamstring muscle lengths were measured before and after the KT. Repeated measures ANOVA was used to compare the means in the study groups before and after the intervention. Results: The mean of right and left PT and lumbar lordosis angles in groups with 115 and 140% tensions before and after the intervention were statistically different (P

ObjectiveTo describe risk factors associated with demographics, training, and competition for iliopsoas injury in dogs participating in agility competitions, as well as describe owner reported treatment and return to sport following injury.ProceduresAn internet-based survey of agility handlers collected risk factor data for dogs participating in agility. Owners were asked questions about demographics, training, and competition as well as injury treatment and recovery if applicable. Associations between variables of interest and iliopsoas injury were estimated with logistic regression. The final risk factor model was built via modified backward selection, with all variables in the final model showing significant associations at p < 0.05.ResultsOf the 4,197 dogs in the sample, 327 (7.8%) reported iliopsoas injury. The final model identified six risk factors for iliopsoas injury. A higher risk of iliopsoas injury was observed for the Border Collie breed, dogs with handlers who are veterinary assistants, dogs competing on dirt, dogs competing on artificial turf 6+ times a year, and dogs that trained with the 2 × 2 method for weave poles. Dogs that were not acquired with agility in mind were observed to have a decreased risk of injury. Factors like number of competition days and jump height were not significantly associated with risk of iliopsoas injury. Owners sought veterinary care for 88% of dogs with iliopsoas injury, including specialty care for 63%. Treatment most often included rest, home rehabilitation, formal rehabilitation, and/or oral medications. Most dogs (80%) were able to return to sport within 6 months, while 20% were out for longer than 6 months, or retired.Conclusion and Clinical RelevanceIliopsoas injury can necessitate a significant amount of time off from training and competition, and even lead to retirement of dogs competing in agility. Some of the risk factors identified in this study can inherently not be modified (breed, intended use, and handler profession), but can be taken into consideration for injury prevention strategies. Competition and training risk factors that can be modified, such as weave training, may help to inform guidelines for best practices in management of the agility athlete.

Background: Hip flexor muscles' tightness has been considered as one of the main risk factors for neuromuscular impairment of lower extremities not only lead to change the movement patterns but also probably result in changing the neuromuscular features of other muscles. The purpose of this research is study was to evaluate the iliopsoas tightness’ effect on electromyographic activity of hip extensor synergists during gait. Methods: In this case-control study fifteen 11-14 years old adolescents with iliopsoas tightness as experimental group, and 15 healthy adolescents which matched based on age, height, weight, body mass index, dominant leg and sport experience participated voluntarily as control group. Surface electromyographic activity of the gluteus maximus, adductor magnus and biceps femoris, were measured between groups during stance phase of gait. Results: Individuals with restricted hip flexor muscle length demonstrated more gluteus maximus activation during terminal stance (p=.001), more biceps femoris activation during mid stance (p=.002) and late stance (p=.001) and more adductor magnus activation during mid stance (p=.04) and late stance (p=.001). Conclusion: Adolescent soccer athletes with hip flexor muscle tightness exhibit more biceps femoris and adductor magnus and gluteus maximus activation during stance phase of gait. Thus, individuals with hip flexor muscle tightness appear to utilize different neuromuscular strategies to control lower extremity motion.

Snapping hip is a common cause of hip complaints, so radiologists should have it on their radar when involved in the workup and care of young patients with hip complaints, especially those whose symptoms are localized to the greater trochanter or iliopsoas. Although history and physical examination often suggest the correct diagnosis, imaging evaluation, including ultrasonography and MR imaging, is valuable to identify responsible extra-articular structures, assess for the presence of any concurrent intra-articular pathology, identify underlying anatomic variants that might necessitate alterations in surgical technique, and guide steroid injections., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Study Design: Retrospective case-control study.Objective: To evaluate the prevalence of pseudarthrosis following ATP lumbar and lumbosacral fusions.Summary Of Background Data: Pseudarthrosis is a feared complication following spinal fusions and may affect their clinical outcomes. To date there is no sufficient data on the fusion rate following antepsoas (ATP) lumbar and lumbosacral arthrodesis.Methods: This is a retrospective review of 220 patients who underwent lumbar MIS-ATP fusions between January 2008 and February 2019 who have at least one-year postoperative computed tomography (CT) follow-up scans. Fusion was graded using CT scans imaging and adopting a 1-4 grading scale (1-definitely fused, 2-likely fused, 3-likely not fused, 4-definitely not fused/nonunion). Grades 3 or 4 indicate pseudarthrosis.Results: A total of 220 patients [average age: 66 years, 82 Male (37.2%), and 127 (57.7%) smokers] were included. Eight patients (3.6%) developed pseudarthrosis. A total of 693 discs were addressed using the ATP approach. Of those, 681 (98.3%) were considered fused [641 levels (92.5%) were "definitely fused" and 40 levels (5.8%) were "Likely fused"] and 12 discs (1.7%) developed pseudarthrosis [7 levels (1.0%) were "likely not fused" and 5 levels (0.7%) were "definitely not fused"]. The highest rate of pseudarthrosis was found at L5-S1 (4.8%) compared to the L1-L5 discs (0-2%). Of 127 smokers, 6 developed pseudarthrosis (Odds Ratio = 2.3, p = 0.3). The fusion rates were 95.3% and 97.8% for smokers and nonsmokers, respectively. Of the eight patients who developed pseudarthrosis, only 4 (50%) were symptomatic, of whom 2 (25%) required revision surgery. Both of these patients were smokers. The overall revision rate due to pseudarthrosis was 0.9% (2/220 patients).Conclusion: The MIS-ATP technique results in a high fusion rate (96.4% of patients; 98.3% of levels). Pseudarthrosis was noted mostly at the L5-S1 discs and in smokers.Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

OBJECTIVES The purpose of this study was to investigate the difference in the cross - sectional area (CSA) of multifidus and Iliopsoas muscles and the lumbar extension muscle strength according to degenerative spinal diseases (LHI; lumbar herniation of intervertebral disc group, SS; spinal stenosis group, S; spondylolisthesis group). METHODS The CSA of multifidus and Iliopsoas muscles size were measured by PACS(Picture Achiving and Communication System) using MRI at the L4/5 level and lumbar extension muscle strength (72˚, 60˚, 48˚, 36˚, 24˚, 12˚, 0˚) was measured using lumbar extension machine(MedX) in 97 patients of degenerative spinal diseases(male: 57, female: 40). The collected data were analyzed by one-way ANOVA using the SPSS program. RESULTS The results of this study showed that the CSA of total and right multifidus muscle in the LHI was significantly higher than that of the S (p

In patients with total hip arthroplasty (THA) with recurrent pain, symptoms may be caused by several conditions involving not just the joint, but also the surrounding soft tissues including tendons, muscles, bursae, and peripheral nerves. US and US-guided interventional procedures are important tools in the diagnostic work-up of patients with painful THA given that it is possible to reach a prompt diagnosis both directly identifying the pathological changes of periprosthetic structures and indirectly evaluating the response and pain relief to local injection of anesthetics under US monitoring. Then, US guidance can be used for the aspiration of fluid from the joint or periarticular collections, or alternatively to follow the biopsy needle to collect samples for culture analysis in the suspicion of prosthetic joint infection. Furthermore, US-guided percutaneous interventions may be used to treat several conditions with well-established minimally invasive procedures that involve injections of corticosteroid, local anesthetics, and platelet-rich plasma or other autologous products. In this review, we will discuss the clinical and technical applications of US-guided percutaneous interventional procedures in painful THA that can be used in routine daily practice for diagnostic and therapeutic purposes.

Introduction: This report aims to describe the epidemiology, clinical presentation, diagnostic workup, treatment, and rehabilitation, natural course, and possible risk factors of the rare entity spontaneous iliopsoas tendon rupture.Methods: One case of spontaneous iliopsoas tendon rupture was encountered. The patient was followed during the hospital stay, her journal was later reviewed, and one telephone follow-up after 90 days was performed. Structured reviews of the literature in the PudMed and Micromedex databases were performed.Results: The patient recovered fully within 6 weeks of conservative treatment with small doses of acetaminophen and opioid. The literature reviews yielded 14 previously reported spontaneous iliopsoas tendon ruptures but no strong evidence regarding possible risk factors.Conclusion: Spontaneous iliopsoas tendon rupture is a rare event, typically occurring in the elderly female. MRI is generally diagnostic, but signs are also often present on CT scans and sometimes even on plain X-ray. Conservative treatment has an excellent prognosis of full recovery within 6 weeks. The evidence on possible risk factors is scarce and conflicting. [ABSTRACT FROM AUTHOR]

Abstract Achilles tendon rupture is a well‐documented adverse effect of Fluoroquinolones; however, herein we present a case of complete iliopsoas and Achilles, and partial semimembranosus tendon rupture secondary to Levofloxacin.

Purpose: The purpose of this article was to report prevalence of iliopsoas pathology in patients undergoing hip arthroscopy for femoroacetabular impingement (FAI), incidence of rendered tenotomy, and outcomes of hips with iliopsoas involvement compared with those with primary FAI.Methods: A cohort study from a hip arthroscopy study group using a prospectively-collected multicenter database was performed. Patients who underwent isolated hip arthroscopy for FAI from January 2016 to March 2017 were assigned to the Iliopsoas group (defined as preoperative diagnosis of coxa saltans internus, intraoperative anteroinferior labral bruising or tear, and preoperative positive psoas injection) or control group. The prevalence of iliopsoas pathology, radiographic and intraoperative findings, and rendered procedures between groups were compared. Mean 2-year (minimum 1.8 year) outcomes of iliopsoas groups with and without rendered tenotomy and a control group were compared.Results: There were 1393 subjects, of which 92 (7%) comprised the iliopsoas study group with 1301 subjects control subjects. Sixteen subjects in the iliopsoas group received tenotomy (17% of iliopsoas group, 1% of all subjects), whereas 76 subjects (83% of iliopsoas group) with iliopsoas involvement did not. There was significant effect on postoperative International Hip Outcome Tool-12 (iHOT-12) scores based on iliopsoas involvement and treatment, F(2,1390) = 3.74, P = .02. Compared with the control group (M = 73, standard deviation [SD] = 24), the non-tenotomized iliopsoas group (M = 69, SD = 32) had similar postoperative scores (P = .46), whereas the tenotomized iliopsoas group (M = 57, SD = 28) averaged lower postoperative scores (P = .03). In the tenotomy group, 25% achieved the iHOT-12 substantial clinical benefit and patient acceptable symptomatic state value for normal function and 100% satisfaction, compared to 49% and 41% for the without tenotomy and control groups.Conclusions: Tenotomy in patients with iliopsoas pathology undergoing arthroscopic surgery for FAI is infrequently performed and is associated with poorer outcomes. Co-afflicted patients treated without tenotomy have similar successful outcomes to patients with primary FAI. Indiscriminate tenotomy for iliopsoas pathology in this setting should be cautiously considered.Level Of Evidence: Level III, cohort study. [ABSTRACT FROM AUTHOR]

The athlete's hip is complex when it comes to the surrounding musculature—approximately 21 different muscles can cross the hip and pelvis region, all synchronously working to maintain pelvic stability and functional hip activities. Commonly injured muscle groups for high-level athletes include flexors, adductors, abductors, and/or proximal hamstring musculotendinous complex. These muscle groups work in harmony; however, each has an independent function and propensity for injury. Rehabilitation phases for each injury group can be broken down into 3 phases: acute management, strengthening, and return-to-sport or return-to-competition phase. Specific rehabilitation principles and modalities are described for each injury group. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Tabriz University of Medical Sciences is the property of Tabriz University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Arthroscopic iliopsoas tendon release is a surgical treatment option for painful snapping hips, although it has been associated with controversy surrounding potential complications including decreased hip flexion strength, iatrogenic hip instability, and iliopsoas atrophy. Purpose: To systematically assess the efficacy and safety of arthroscopic iliopsoas tenotomy during hip arthroscopic surgery as an intervention for painful snapping hips. Study Design: Systematic review; Level of evidence, 4. Methods: A total of 3 online databases (Embase, PubMed, and MEDLINE) were searched from database inception until September 2019 for studies investigating iliopsoas tenotomy during hip arthroscopic surgery. Studies were screened by 2 reviewers independently and in duplicate, and studies investigating arthroscopic iliopsoas tendon release were included. Demographic data as well as data on treatment success, functional outcome scores, and radiological outcomes were recorded. A risk of bias assessment was performed for all included studies. Results: Overall, 21 studies were identified with a total of 824 patients (875 hips). These patients were 82.5% female (680/824), with a mean age of 28.1 years (range, 12-62 years) and mean follow-up of 32.1 months (range, 3-73 months). Arthroscopic iliopsoas tenotomy was performed at the level of the labrum in 811 hips (92.7%) or the lesser trochanter in 64 hips (7.3%). The overall reported success rate of the procedure in resolving snapping hips was 93.0% (266/286), and all studies reported an improvement in functional outcome scores. Only 6 studies (93 hips) discussed postoperative hip flexion strength, with complete recovery of strength reported in 4 studies (47 hips) and mild decreases reported in the other 2 studies (46 hips). Iliopsoas atrophy was evaluated radiologically (3 studies; 66 hips) and was found postoperatively in 92.4% (61/66) of hips. No major complications were reported. Conclusion: Arthroscopic release of the iliopsoas tendon was effective in alleviating pain and persistent clicking associated with a snapping hip. Although patients demonstrated some early postoperative weakness and iliopsoas atrophy on radiological imaging, the results from studies to date showed satisfactory clinical function and return to sports/activities. High-quality comparative studies are needed to further assess arthroscopic iliopsoas tendon release to determine the optimal technique and location of tendon release. [ABSTRACT FROM AUTHOR]

Background: The Psoas Minor (PMi) is the most unstable muscle of the psoas group of the posterior abdominal muscle. This muscle has a fusiform shape and consists of a short fusiform belly continuing distally as a long tendon inserted on the pecten pubis and the iliopectineal arch. The present study was conducted to obtain more detailed information about the muscle and to expand knowledge about its morphology and morphometry., Materials and Methods: The posterior abdominal wall of 30 adult cadavers was dissected. Anatomical variabilities in origin, insertion, length, width, and muscle-to-cone ratio were measured when PMi was found. The data collected was interpreted descriptively., Results: PMi was found in 12 cases, ten bilateral and two unilateral. The origin was constant in all cases and, except for three cases, extended into the iliac fascia and the iliopubic eminence. Morphometric analysis revealed that the average length of the proximal muscle belly and distal tendons was 4.52 ± 1.35 cm and 13.05 ± 0.90 cm, respectively. The mean width of the muscle belly was 1.71 ± 0.17 cm, and that of the tendon was 0.47 ± 0.10 cm. On average, the muscle belly occupied the proximal 33.71 ± 6.15% of the total musculotendinous unit., Conclusions: Findings confirm the inconsistency of PMi in the study population. Morphological variations became more evident as the tendon approached the insertion level. The muscle's distal attachment to the iliac fascia may partially control the position, mechanical stability of the underlying iliopsoas and this circumstantial function may be clinically related to iliopsoas inflammation and pathology. However, further studies recommended to determine biomechanical validity and clinical applicability of this vestigial muscle in human.

Iliopsoas tendon tears are rare. These typically occur in young and can be associated with avulsion fractures of lesser trochanter. We report a case of full thickness rupture of iliopsoas tendon in 87-year-old male without avulsion of the lesser trochanter.

Introduction: Sprints combined with changes in direction and repeated lunges are the most frequent movements during a squash game. These motions overload the iliopsoas muscle which may cause a lot of microinjuries. Accumulating microinjuries combined with a lack of stretching exercises may lead to iliopsoas contracture. Aim of the study: Assessment of the frequency and degree of iliopsoas contracture in regular squash players. Material and methods: The experimental group comprised 25 regular squash players (minimum 2 years of playing at least twice a week) and 21 non-players (control group). A modified Thomas Test was used to assess iliopsoas contracture using goniometric and linear measurements. Results: Iliopsoas contracture was observed in 96% of the squash players and 66.7% of the non-players (p = 0.0089). The degree of muscle contracture in the goniometric measurement was greater in squash players than in the non-players in both the left (p = 0.0303) and right (p = 0.0007) iliopsoas muscles. There were no statistically significant differences in the linear measurement. Conclusions: There is a positive relationship between regularly playing squash and the frequency of iliopsoas contracture occurrence being significantly greater in squash players than in non-players.

Many recent studies have highlighted that the harmony of physiological walking is based on a specific proportion between the durations of the phases of the gait cycle. When this proportion is close to the so-called golden ratio (about 1.618), the gait cycle assumes an autosimilar fractal structure. In stroke patients this harmony is altered, but it is unclear which factor is associated with the ratios between gait phases because these relationships are probably not linear. We used an artificial neural network to determine the weights associable to each factor for determining the ratio between gait phases and hence the harmony of walking. As expected, the gait ratio obtained as the ratio between stride duration and stance duration was found to be associated with walking speed and stride length, but also with hip muscle forces. These muscles could be important for exploiting the recovery of energy typical of the pendular mechanism of walking. Our study also highlighted that the results of an artificial neural network should be associated with a reliability analysis, being a non-deterministic approach. A good level of reliability was found for the findings of our study.

Muscular metastases (MMs) form an infrequent entity, and their physiopathology is still not well-defined. In this study, we estimated the incidence of MMs that were detected by 18F-fluorodeoxyglucose positron emission tomography/computed tomography and also specified their metabolic characteristics. This study includes 13 patients with MMs from a remotely located primary tumor. The results of this study showed an incidence of MMs at about 1%, with the most frequently involved muscles being iliopsoas and paraspinal. Lung cancer seems to be the most common tumor that causes MMs. Furthermore, these MMs vary in size and physiological uptake; they seem to be out of the ordinary and easily detected. They are often associated with other extra muscular locations and frequently involve the trunk muscles. Their detection in the course of the evolution of a specific neoplasia testifies to their aggressiveness and portends an unfavorable prognosis. The data in our series confirm that in the literature regarding the underlying primary tumors and anatomical sites involved by MMs. [ABSTRACT FROM AUTHOR]

It is hypothesized that the subtalar hyperpronation may provoke the development of a biomechanical chain of events in lower extremity alignment. Several studies have shown that pelvic alignment may alter in the presence of immediate foot hyperpronation induced by external forces. It is unknown whether these alterations are presented in chronic foot hyperpronation or not. It is also unknown if these potential postural changes could affect iliopsoas muscle size. Therefore, it appears necessary to carry out thorough research in this study. Twenty nine females with pronated foot posture and twenty seven females with normal foot posture participated in this study. The iliopsoas muscle was measured using ultrasound imaging (USI). Pelvic angle (PA) was measured using reflective markers and digital photography. Intrarater reliability of USI for the iliopsoas muscle thickness was also measured. The results indicated that the iliopsoas muscle thickness and the PA were not different in individuals with pronated foot compared to the normal foot group. However, a good intrarater reliability of USI was found for measuring the iliopsoas muscle thickness. [ABSTRACT FROM AUTHOR]