Spontaneous iliopsoas tendon rupture: a case report and brief review

Stark, Joachim

doi:10.1007/s00402-020-03523-2

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…A small study of 19 military subjects demonstrated that MRI was 100% accurate in delineating the aetiology of acute hip pain, including iliopsoas tear injuries, in young endurance athletes (15). Although the participants in this study were of a young and athletic population, multiple case studies have demonstrated the ability of MRI to diagnose iliopsoas tears in the older adult population (3,4,6,8,13,14). Findings of abnormal signal intensity on T1 and T2-weighted images, proximal muscle thickening, mass effect on the anterior hip joint, and interruption of the psoas tendon with preserved lateral iliacus muscle insertion fibres are consistent with a rupture of the distal iliopsoas tendon (4).…”

Section: Discussionmentioning

confidence: 90%

“…Treatment for strains and partial tears is usually conservative, including physical therapy and pain management (6). There is a paucity of literature on iliopsoas rupture treatment, including surgical management.…”

Section: Discussionmentioning

confidence: 99%

“…However, complete iliopsoas ruptures can occur even from minor trauma, such as a minor fall from standing height. A few spontaneous injuries have even been reported (3)(4)(5)(6)(7)(8). There is a paucity of literature on iliopsoas rupture in the older adult population, and the true incidence of iliopsoas tears is therefore probably under-reported.…”

mentioning

confidence: 99%

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Rare Case of Hip Pain Due to Iliopsoas Tendon Rupture; A Case Report and Review of the Literature

Anders¹,

Vitale²

2022

JRM-CC

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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 ABSTRACTHip 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.

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