Anatomy, pathology, imaging and intervention of the iliopsoas muscle revisited

Abstract

The apparent incidence of iliopsoas muscle abnormalities is currently rapidly increasing secondary to the increased number of immuno-compromised patients, malignancies, chemotherapy, immunotherapy, multi-systemic disease and the wide availability of cross-sectional imaging. Disease of the iliopsoas compartment can present with non-specific or indolent clinical features, particularly where normal immune responses are attenuated. Delay in diagnosis can lead to inappropriate initial treatment and, in some cases, serious complications. Wider availability and application of modern cross-sectional imaging offers rapid, confident diagnosis. An understanding of iliopsoas compartment anatomy and pathways of disease spread are essential to recognising these clinically important conditions. We review the anatomy, clinical presentation and common imaging findings of iliopsoas disease as it presents through the emergency room.

Features and treatment modality of iliopsoas abscess and its outcome: a 6-year hospital-based study

“…Because of the rapid progress in advanced imaging techniques, such as gallium-67 scanning, computed tomography (CT), and magnetic resonance image (MRI) in recent years, early diagnosis of IPA has become easier despite initial clinical presentation that is frequently ambiguous [6-8]. Although origin-based IPA classification has been adopted in clinical practice, it does not help clinicians make appropriate treatment decisions.…”

Iliopsoas tuberculous abscess associated with cervical and axillary tuberculous lymphadenopathy

“…Some of these indications are: (a) a marked neurological deficit, especially related to severe kyphosis or retropulsed bone or disc, (b) large abscesses causing respiratory impairment, (c) neurological deficit that has worsened despite adequate chemotherapy for 3–4 weeks, (d) continued progression of kyphosis or instability, despite adequate chemotherapy, especially where three or more vertebra are involved, or with posterior element involvement and (e) multiloculated abscesses or failure of percutanous drainage 10 11. We should mention that our patient did not fulfil any of the above criteria at the initial presentation.…”

Variety of Clinical Manifestations of Rupture of Iliopsoas Muscle Belly

“…As an analogy to this case may serve the IPM bleedings that affect the hemophiliacs. Dauty described such hemorrhages in 5 hemophiliac patients over the period of five years (10). On the other hand, these bleedings may affect the elderly without concomitant diseases.…”