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Iliopsoas tear

F Winston Gwathmey, Kay S Jones, J W Thomas Byrd
The purpose of this study is to report on the operative findings and the outcomes of revision hip arthroscopy. All hip arthroscopy cases are prospectively assessed with a modified Harris Hip Score (mHHS) preoperatively and postoperatively. This study consists of 190 consecutive hips (186 patients) who underwent revision arthroscopy with minimum 2-year follow-up. There were 69 males and 117 females with a mean age of 32.7 (14-64). The mean time from index to revision procedure was 24.5 months (3-146). Common diagnoses included labral tears (102) and unaddressed or residual femoroacetabular impingement (FAI) (49 cam, 11 pincer, and 20 combined)...
December 2017: Journal of Hip Preservation Surgery
Sivashankar Chandrasekaran, Nader Darwish, Edwin O Chaharbakhshi, Parth Lodhia, Carlos Suarez-Ahedo, Benjamin G Domb
PURPOSE: To report on patterns of clinical presentation, intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopy (HA) in patients 18 years or younger. METHODS: This study was a retrospective case series on patients 18 years or younger who had undergone HA for labral tears that had failed nonoperative management from April 2008 to April 2013 with a minimum 2-year follow-up. Exclusion criteria were previous hip conditions or surgery...
July 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Frantz R Lerebours, Randy Cohn, Thomas Youm
Greater trochanteric pain syndrome (GTPS) is a term used to describe disorders of the peritrochanteric region. This constellation of conditions includes greater trochanteric bursitis, gluteus medius (GM) tears, and external coxa saltans or snapping hip syndrome. Tears of the abductor mechanism, more specifically gluteus medius tears, have recently gained a considerable amount of interest in the orthopaedic literature. Abductor tears were first described by Bunker and Kagan in the late 1990s. They used the rotator cuff as an analogous structure to describe the pathological process associated with gluteus medius tears...
March 2016: Bulletin of the Hospital for Joint Diseases
Manolo Rubio, Mary Rodriguez, Soumya Patnaik, Peter Wang
Hip pain is one of the most common reasons for the elderly to present to the emergency department, and the differential diagnosis spectrum is vast. Iliopsoas injury is a relatively uncommon condition that may present with hip or groin pain. It is usually seen in athletes due to trauma, particularly flexion injuries. However, spontaneous iliopsoas tendon tear is extremely rare, and only a small number of cases have been reported; it has an estimated prevalence of 0.66% in individuals from 7 to 95 years. Risk factors include aging, use of steroids, and chronic diseases...
March 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Andrew S Chi, Suzanne S Long, Adam C Zoga, Paul J Read, Diane M Deely, Laurence Parker, William B Morrison
PURPOSE: To evaluate gluteus medius and minimus tendon pathology and muscle atrophy in older individuals using MRI. METHODS: A retrospective MRI study of 185 individuals was performed. The inclusion criterion was age ≥50. Exclusion criteria were hip surgery, fracture, infection, tumor, or inadequate image quality. Greater trochanteric bursitis was graded none, mild, moderate, or severe. Gluteus medius, gluteus minimus, and iliopsoas tendinopathy was graded normal, tendinosis, low-grade partial tear, high-grade partial tear, or full thickness tear...
December 2015: Skeletal Radiology
Mohammed Emam, Constantine Farmakidis, Se Won Lee, Stanley F Wainapel
Iliopsoas tendon rupture is a relatively rare cause of hip pain. It has been described in children, in adults with pathologic avulsion secondary to metastatic disease, and in older individuals with multiple chronic illnesses. We are reporting a case of apparently spontaneous iliopsoas tendon rupture that occurred in an elderly patient presenting with severe debilitating hip pain whose etiology initially was unrecognized. Magnetic resonance imaging of the hip confirmed the diagnosis. This case highlights the importance of considering iliopsoas tear in the differential diagnosis of unexplained acute onset hip pain and illustrates that geriatric patients with this condition can be treated conservatively with satisfactory functional outcome...
January 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Jon A Jacobson, Viviane Khoury, Catherine J Brandon
OBJECTIVE: In a patient with symptoms referable to the groin, there can be a number of causes to consider and at times the cause of the symptoms is multifactorial. Although ultrasound can be effective in the evaluation of the groin, the depth and complexity of the anatomy can be problematic. A protocol-driven approach for ultrasound evaluation of the groin will help to ensure an accurate and comprehensive evaluation. This article summarizes the ultrasound technique and protocol for evaluation of the groin to include evaluation of the hip joint, anterior hip musculature, the iliopsoas bursa, the inguinal lymph nodes, the pubic symphyseal region, and the inguinal region for hernias...
September 2015: AJR. American Journal of Roentgenology
Alan T Rankin, Chris M Bleakley, Michael Cullen
BACKGROUND: Chronic hip and groin pain offers a diagnostic challenge for the sports medicine practitioner. Recent consensus suggests diagnostic categorization based on 5 clinical entities: hip joint-, adductor-, pubic bone stress injury-, iliopsoas-, or abdominal wall-related pathology. However, their prevalence patterns and coexistence in an active population are unclear. PURPOSE: This study presents a descriptive epidemiology based on a large sample of active individuals with long-standing pain in the hip and groin region...
July 2015: American Journal of Sports Medicine
Youssef F El Bitar, Christine E Stake, Kevin F Dunne, Itamar B Botser, Benjamin G Domb
BACKGROUND: Internal snapping of the hip is caused by the iliopsoas (IP) tendon sliding over the iliopectineal eminence or the femoral head. In many cases that require hip arthroscopic surgery, there is coexistent painful internal snapping. In such cases, fractional lengthening of the IP tendon has been suggested as an adjunctive procedure. PURPOSE: To examine the outcomes and effectiveness of arthroscopic IP tendon fractional lengthening as a solution to coexistent internal hip snapping in patients undergoing hip arthroscopic surgery for a labral tear and/or femoroacetabular impingement...
July 2014: American Journal of Sports Medicine
Kara Gaetke-Udager, Gandikota Girish, Ravi K Kaza, Jon Jacobson, David Fessell, Yoav Morag, David Jamadar
Occasionally patients who undergo magnetic resonance imaging for presumed pelvic disease demonstrate unexpected musculoskeletal imaging findings in the imaged field. Such incidental findings can be challenging to the abdominal radiologist, who may not be familiar with their appearance or know the appropriate diagnostic considerations. Findings can include both normal and abnormal bone marrow, osseous abnormalities such as Paget's disease, avascular necrosis, osteomyelitis, stress and insufficiency fractures, and athletic pubalgia, benign neoplasms such as enchondroma and bone island, malignant processes such as metastasis and chondrosarcoma, soft tissue processes such as abscess, nerve-related tumors, and chordoma, joint- and bursal-related processes such as sacroiliitis, iliopsoas bursitis, greater trochanteric pain syndrome, and labral tears, and iatrogenic processes such as bone graft or bone biopsy...
August 2014: Abdominal Imaging
M Dilani Mendis, Stephen J Wilson, David A Hayes, Mark C Watts, Julie A Hides
Acetabular labral tears are a source of hip pain and are considered to be a precursor to hip osteoarthritis. Hip flexor muscles contribute to hip joint stability and function but it is unknown if their size and function is altered in the presence of labral pathology. This study aimed to investigate hip flexor muscle size, strength and recruitment pattern in patients with hip labral pathology compared to control subjects. 12 subjects diagnosed with an unilateral acetabular labral tear were compared to 12 control subjects matched for age and gender...
October 2014: Manual Therapy
Sommer Hammoud, Asheesh Bedi, James E Voos, Craig S Mauro, Bryan T Kelly
CONTEXT: In active individuals with femoroacetabular impingement (FAI), the resultant reduction in functional range of motion leads to high impaction loads at terminal ranges. These increased forces result in compensatory effects on bony and soft tissue structures within the hip joint and hemipelvis. An algorithm is useful in evaluating athletes with pre-arthritic, mechanical hip pain and associated compensatory disorders. EVIDENCE ACQUISITION: A literature search was performed by a review of PubMed articles published from 1976 to 2013...
March 2014: Sports Health
Donna G Blankenbaker, Michael J Tuite
Femoroacetabular impingement is one of the causes of hip pain leading to acetabular labral tears and cartilage damage that may lead to the development of early osteoarthritis. More recently other causes of impingement have been recognized that may be the culprit for the painful hip. These causes include ischiofemoral, anterior inferior iliac spine/subspine and iliopsoas impingement. Ischiofemoral impingement syndrome is related to narrowing between the ischial tuberosity and lesser trochanter with abnormalities of the quadratus femoris muscle producing hip pain...
July 2013: Seminars in Musculoskeletal Radiology
Abdel Rahman Aly, Sathish Rajasekaran, Haron Obaid
OBJECTIVE: Anterior (3 o'clock) acetabular labral tears (AALTs) have been reported to be associated with iliopsoas impingement (IPI). However, no study has examined the association between anatomical bony variables of the hip joint and AALTs. The purpose of this study was to evaluate the association between AALTs, femoroacetabular impingement (FAI) and other bony variables of the hip. MATERIAL AND METHODS: Seventy-six out of 274 hip MRI records met the inclusion criteria...
September 2013: Skeletal Radiology
Véronique Freire, Nathalie J Bureau, Mélanie Deslandes, Thomas Moser
Hip pain is a common clinical presentation of elderly patients in the emergency department. We report the clinical and imaging findings in 4 elderly patients with iliopsoas tendon tears who presented at our institution between October 2009 and June 2010. In 2 patients, the imaging diagnosis was significantly delayed. This injury is uncommon, and the clinical presentation in these patients may be misleading. Magnetic resonance is the imaging modality of choice after radiographs to assess these patients, and knowledge of the complex anatomy of the iliopsoas myotendinous unit helps in making the correct diagnosis...
August 2013: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Cara L Lewis
CONTEXT: Snapping hip, or coxa saltans, is a vague term used to describe palpable or auditory snapping with hip movements. As increasing attention is paid to intra-articular hip pathologies such as acetabular labral tears, it is important to be able to identify and understand the extra-articular causes of snapping hip. EVIDENCE ACQUISITION: The search terms snapping hip and coxa sultans were used in PubMed to locate suitable studies of any publication date (ending date, November 2008)...
May 2010: Sports Health
Donna G Blankenbaker, Michael J Tuite, James S Keene, Alejandro Munoz del Rio
OBJECTIVE: Iliopsoas impingement is a new arthroscopic diagnosis that refers to an anterior labral injury caused by the iliopsoas tendon. Currently, there are no preoperative criteria to establish the diagnosis of iliopsoas impingement. The goal of this study was to determine whether there are imaging criteria that would identify iliopsoas impingement on preoperative MR arthrography. MATERIALS AND METHODS: This study compared the preoperative MR arthrograms of 23 patients who had iliopsoas impingement diagnosed at hip arthroscopy with the arthrograms of 24 patients who did not have iliopsoas impingement found at hip arthroscopy...
October 2012: AJR. American Journal of Roentgenology
Marc Tey, Sonia Alvarez, Jose L Ríos
Hip labral impingement can cause labral tears and secondary paralabral cyst formation. Femoroacetabular impingement is the main cause of labral impingement, but other conditions such as iliopsoas tendon impingement are described. There is no description of labral cyst resulting from psoas impingement treated arthroscopically in the literature. We present the case of a young sportsman with groin pain caused by psoas impingement with a labral tear and secondary paralabral cyst who was treated arthroscopically by cyst debridement, psoas tenotomy, and labral repair...
August 2012: Arthroscopy: the Journal of Arthroscopic & related Surgery
Benjamin G Domb, Michael K Shindle, Benjamin McArthur, James E Voos, Erin M Magennis, Bryan T Kelly
Labral tears typically occur anterosuperiorly in association with femoroacetabular impingement or dysplasia. Less commonly, labral pathology may occur in an atypical direct anterior location adjacent to the iliopsoas tendon in the absence of bony abnormalities. We hypothesize that this pattern of injury is related to compression or traction on the anterior capsulo-labral complex by the iliopsoas tendon where it crosses the acetabular rim. In a retrospective review of prospectively collected data, we identified 25 patients that underwent isolated, primary, unilateral iliopsoas release and presented for at least 1 year follow-up (mean 21 months)...
July 2011: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Olaf Magerkurth, Jon A Jacobson, Gandikota Girish, Monica Kalume Brigido, Asheesh Bedi, David Fessell
PURPOSE: The purpose of this research was to retrospectively characterize paralabral cysts of the hip as seen at MR arthrography. MATERIALS AND METHODS: After Institutional Review Board approval, 704 patients who had MR arthrography were identified over a 3-year period and 40 patients were identified as having a cyst or fluid collection at the hip by MR report. MR images from these 40 patients were retrospectively reviewed by three radiologists where 18 were found to have a paralabral cyst, which were characterized as follows: location, configuration, contrast filling, size of the cyst, extent, direction, and whether associated osseous changes were present...
September 2012: Skeletal Radiology
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