From the Guidelines
Iliopsoas tendinitis presents with pain in the anterior hip or groin that typically worsens with activities involving hip flexion, such as climbing stairs, running, or rising from a seated position, and diagnosis involves a thorough physical examination and imaging studies, with MRI being the most effective for visualizing inflammation of the tendon, as recommended by the most recent and highest quality study 1.
Symptoms of Iliopsoas Tendinitis
- Pain in the anterior hip or groin that worsens with hip flexion
- Deep ache in the groin
- Pain radiating to the front of the thigh
- Discomfort when bringing the knee to the chest
- Snapping sensation in the hip
- Increased pain after prolonged sitting
- Stiffness, especially in the morning
Diagnosis of Iliopsoas Tendinitis
- Thorough physical examination, including specific tests like the Thomas test or resisted hip flexion test to reproduce pain
- Palpation of the iliopsoas tendon for tenderness
- Imaging studies, including:
- MRI: most effective for visualizing inflammation of the tendon
- Ultrasound: useful for dynamic assessment of the tendon during movement
- X-rays: to rule out other conditions like arthritis or bone abnormalities
- Differential diagnosis is important to exclude other conditions that may mimic iliopsoas tendinitis, such as hip osteoarthritis, labral tears, or sports hernias, as noted in 1 and 1.
Importance of Accurate Diagnosis
Accurate diagnosis of iliopsoas tendinitis is crucial to provide appropriate treatment and prevent further complications, as emphasized in 1 and 1. A comprehensive evaluation, including physical examination and imaging studies, is essential to confirm the diagnosis and rule out other conditions.
From the Research
Symptoms of Iliopsoas Tendinitis
- Pain in the groin area, which can radiate down the leg 2
- Pain with activities such as hyperextension of the hip, forced flexion, and activities of daily living (e.g., ascending stairs) 2
- Pain with hip flexion activities and reproducible pain with resisted hip flexion on examination or other provocative iliopsoas maneuvers 3
- Symptoms can begin after a significant increase in physical activity, such as running 4
Diagnosis of Iliopsoas Tendinitis
- Diagnosis can be difficult and may require a combination of clinical evaluation, imaging studies, and diagnostic injections 2, 3
- Ultrasound can be used to diagnose iliopsoas tendinitis and guide diagnostic injections 5
- Magnetic resonance imaging (MRI) can also be used to evaluate the iliopsoas tendon and surrounding structures 2
- A thorough clinical evaluation, including a physical examination and medical history, is essential to diagnose iliopsoas tendinitis and rule out other potential causes of groin pain 6, 3
Diagnostic Challenges
- Iliopsoas tendinitis can be a challenging diagnosis to make, as the symptoms can be non-specific and similar to those of other conditions 2, 3
- A high index of suspicion is necessary to diagnose iliopsoas tendinitis, particularly in patients with a history of hip surgery or trauma 2, 5
- Diagnostic injections can be used to confirm the diagnosis and guide treatment 5, 3