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Chapala S, Mettu S, Shirodkar K, Iyengar KP, Beale D, Botchu R. Isolated spontaneous non-insertional tear of the iliopsoas tendon in an elderly patient: significance of ultrasound imaging. J Ultrasound 2024:10.1007/s40477-024-00945-1. [PMID: 39060719 DOI: 10.1007/s40477-024-00945-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Isolated spontaneous tears in the non-insertional portion of the iliopsoas tendon without any underlying injury are uncommon, especially among elderly individuals. We describe the case of an 88-year-old man who experienced right groin pain caused by a spontaneous non-insertional tear in the iliopsoas tendon identified through ultrasound and confirmed via MRI. Ultrasound revealed hypoechogenicity in the non-insertional portion of the iliopsoas tendon, leading to quick identification and conservative treatment and resulting in positive functional outcomes. This case report emphasises the significance of considering spontaneous non-insertional iliopsoas tendon tears when evaluating cases of acute groin pain. This finding underscores the effectiveness of ultrasound as an initial diagnostic tool for the early cost-effective diagnosis of soft tissue injuries around the hip joint, especially in low-resource settings. Timely detection and management can help avoid unnecessary operative interventions and facilitate faster and better recovery.
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Affiliation(s)
- S Chapala
- Department of Radiology, AIG Hospitals, Hyderabad, India
| | - S Mettu
- Department of Radiology, Himagiri Hospital, Hyderabad, India
| | - K Shirodkar
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - Karthikeyan P Iyengar
- Department of Orthopedics, Southport and Ormskirk Hospital, Mersey and West Lancashire Hospital NHS Trust, Southport, UK
| | - D Beale
- Department of Radiology, Heath Lodge Clinic, Knowle, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, The Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
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Mezian K, Ricci V, Güvener O, Jačisko J, Novotný T, Kara M, Chang KV, Naňka O, Pirri C, Stecco C, Dughbaj M, Jain NB, Özçakar L. EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for (Adult) Hip. Am J Phys Med Rehabil 2022; 101:e162-e168. [PMID: 35687784 DOI: 10.1097/phm.0000000000002061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT In this dynamic scanning protocol, ultrasound assessment of the adult hip is described using different maneuvers for various conditions. Real-time patient examination and ultrasound scanning videos are coupled for convenience as well as for better insight. The text covers the common conditions around the hip where especially dynamic ultrasound scanning provides valuable information in addition to static imaging. The protocol is prepared by an international consensus of several experts in the field of musculoskeletal ultrasound.
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Affiliation(s)
- Kamal Mezian
- From the Department of Rehabilitation Medicine, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic (KM); Physical and Rehabilitation Medicine Unit, Luigi Sacco University Hospital, A.S.S.T. Fatebenefratelli-Sacco, Milan, Italy (VR); Department of Physical and Rehabilitation Medicine, Mersin University Medical School, Mersin, Turkey (OG); Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic (JJ); Department of Orthopaedics, University J.E. Purkinje, Masaryk Hospital, Usti nad Labem, Czech Republic (TN); Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, LÖ); Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (K-VC); National Taiwan University College of Medicine, Taipei, Taiwan (K-VC); Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic (ON); Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padova, Italy (CP, CS); Physical Medicine and Rehabilitation Hospital, Ministry of Health, Kuwait (MD); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ)
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Zunarelli P, Lucenteforte G, Miceli M, Stride M, Nanni G, Della Villa F. The Use of Diagnostic Ultrasound in Sports Muscle Injuries in Football (Soccer) Players: State-of-the-art Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fernández-Carnero S, Garrido-Marín A, Achalandabaso-Ochoa A, Ferragut-Garcías A, Fernández-Matías R, Pecos-Martín D, Gallego-Izquierdo T. Evaluation of the Lower Trapezius Muscle Using Ultrasound Panoramic View (a Novel Approach): An Intra- and Inter-Rater Reliability Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197123. [PMID: 33003390 PMCID: PMC7579079 DOI: 10.3390/ijerph17197123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 11/16/2022]
Abstract
The panoramic view ultrasound remains uncommon in clinical practice, probably because of its difficulty, high-cost, and lack of research. Morphological changes in muscles have been demonstrated to be related to symptomatology and provide data of interest for clinical assessment. Thus, the aim of this study was to evaluate the measurement reliability of the length of the lower trapezius muscle with the panoramic view ultrasound using a novel tool, SIG_VIP®. Twenty healthy volunteers were measured by two expert sonographers using the SIG_VIP® tool with a novel approach. Statistical analyses were performed with the R software. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and Bland-Altman plots were calculated. All the results indicated good intra-rater reliability (ICC3,1, 0.92 to 0.96; SEM, 0.59 to 0.85; MDC, 1.64 to 2.35) and inter-rater reliability (ICC3,2, 0.84 to 0.89; SEM, 1.22 to 1.53; MDC, 3.39 to 4.25). The novel system used with the described methodology can reliably measure the length of the inferior fibers of the trapezius muscle. Further research must be conducted to evaluate the reliability in patients and how pathology is related to the length of the lower trapezius muscle.
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Affiliation(s)
- Samuel Fernández-Carnero
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.F.-C.); (D.P.-M.); (T.G.-I.)
| | | | | | | | - Rubén Fernández-Matías
- Research Institute of Physical Therapy and Pain, Alcalá University, 28871 Alcalá de Henares, Spain;
| | - Daniel Pecos-Martín
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.F.-C.); (D.P.-M.); (T.G.-I.)
| | - Tomás Gallego-Izquierdo
- Department of Physiotherapy and Nursing, Alcalá University, 28871 Alcalá de Henares, Spain; (S.F.-C.); (D.P.-M.); (T.G.-I.)
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Andronic O, Nakano N, Daivajna S, Board TN, Khanduja V. non-arthroplasty iliopsoas impingement in athletes: a narrative literature review. Hip Int 2019; 29:460-467. [PMID: 30942093 DOI: 10.1177/1120700019831945] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Iliopsoas impingement occurs secondary to a tight iliopsoas tendon that causes impingement during movement. This review presents current aspects regarding the diagnosis of iliopsoas impingement and also exposes the readers to the possible anatomic and clinical variations together with the available treatment options. METHODS We conducted a narrative literature review with regard to non-arthroplasty iliopsoas impingement. RESULTS Iliopsoas impingement is characterised by a distinct pattern of labral pathology, with anteriorly localised labral damage, that does not extend to the anterosuperior portion of the acetabulum. Anterior groin pain and intermittent catching, snapping or popping of the hip are common symptoms. Non-specific focal tenderness is often found over the iliopsoas tendon at the level of the anterior aspect of the joint. The 'C-sign' and Impingment test are usually positive. Dynamic ultrasonography is also useful for confirming the diagnosis. Initial management of painful iliopsoas impingement should be conservative. When patients continue to have pain, an ultrasound-guided injection can provide relief and predict the response to the surgical release. For patients who have recurrent pain after local injection of steroids, arthroscopic release has shown to achieve effective results. CONCLUSIONS Although different treatment options for iliopsoas impingement are emerging, the current standard of therapy is conservative followed by an arthroscopic tenotomy if necessary. Young adult hip surgeons should always keep this differential in mind in a patient presenting with groin pain and mechanical symptoms.
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Affiliation(s)
- Octavian Andronic
- 1 Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland
| | - Naoki Nakano
- 2 Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge, UK
| | - Sachin Daivajna
- 3 Department of Orthopaedics, Peterborough City Hospital, Peterborough, UK
| | - Tim N Board
- 4 Department of Orthopaedics, Wrightington Hospital, Wigan, UK
| | - Vikas Khanduja
- 2 Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge, UK
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Abstract
Traumatic and overuse hip injuries occur frequently in amateur and professional athletes. After clinical assessment, imaging plays an important role in diagnosis and in defining care management of these injuries. Ultrasonography (US) is being increasingly used in assessment of hip injuries because of the wide availability of US machines, the lower cost, and the unique real-time imaging capability, which allows both static and dynamic evaluation as well as guidance of point-of-care interventions such as fluid aspiration and steroid injection. Accurate diagnosis of hip injuries is often challenging, given the complex soft-tissue anatomy of the hip and the wide spectrum of injuries that can occur. To conduct a skillful US evaluation of hip injuries, physicians must have pertinent knowledge of the normal anatomy and should make judicious use of surface anatomy landmarks while using a compartmentalized diagnostic approach. In this article, common sports-related injuries of the anterior, lateral, and posterior hip compartments are discussed. This review includes assessment of joint effusion, acetabular labral tear, acute and chronic tendon injuries including tendinopathy, partial and full-thickness tears, snapping hip syndromes, relevant US-guided procedures, and some other conditions such as Morel-Lavallée lesion and perineal nodular induration. Principles of care management and current knowledge on imaging findings that may affect return to activity are also presented. Using an oriented US examination technique and having knowledge of the normal hip anatomy will help physicians characterize US findings of common sports-related hip injuries and make accurate diagnoses. Online supplemental material is available for this article. ©RSNA, 2018.
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Affiliation(s)
- Eugen Lungu
- From the Department of Radiology (E.L., N.J.B.), Department of Medicine (J.M.), and Research Center (N.J.B.), Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC, Canada H2X 0C1
| | - Johan Michaud
- From the Department of Radiology (E.L., N.J.B.), Department of Medicine (J.M.), and Research Center (N.J.B.), Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC, Canada H2X 0C1
| | - Nathalie J Bureau
- From the Department of Radiology (E.L., N.J.B.), Department of Medicine (J.M.), and Research Center (N.J.B.), Centre Hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC, Canada H2X 0C1
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