From the Guidelines
Iliopsoas tendinitis is a type of extra-articular noninfectious soft tissue abnormality.
Causes and Diagnosis
- It is a condition that affects the iliopsoas tendon, which is a muscle that runs from the lower back down to the femur (thigh bone) [ 1 ].
- The diagnosis of iliopsoas tendinitis can be made using imaging modalities such as MRI and US, which are highly sensitive and specific for detecting soft tissue abnormalities [ 1 ].
- MRI is particularly useful for examining surrounding soft tissue entities such as iliopsoas or subiliacus bursitis, athletic pubalgia, trochanteric bursitis, abductor tendinosis or tears, calcific tendonitis, and hamstring injuries [ 1 ].
Imaging Modalities
- US can be used to localize fluid collections, such as paralabral cysts, for aspiration and injection, and can also be used to evaluate snapping hip [ 1 ].
- CT is less sensitive for soft tissue evaluation, but can be used to define the complex bony anatomy of the hip [ 1 ].
- Nuclear medicine does not currently play a role in the workup of iliopsoas tendinitis [ 1 ].
Treatment
- Diagnostic and therapeutic injections, such as intra-articular injections of anesthetic and steroid, can provide diagnostic information and be therapeutic [ 1 ].
- US-guided injections can be used to guide injections and provide relief from pain [ 1 ].
From the Research
Definition and Overview
- Iliopsoas tendinitis is a condition characterized by inflammation of the iliopsoas tendon, which can cause hip pain and discomfort 2, 3, 4.
- The iliopsoas tendon is a conjoint tendon of the psoas major and iliacus muscles, and anatomic variance has been reported, with some individuals having two or more distinct tendons 5.
Symptoms and Diagnosis
- Common symptoms of iliopsoas tendinitis include pain in the ilio-inguinal area, lameness, continuous fever, tenderness, and a palpable infiltrate in the area of the iliac-psoas muscles 4.
- Diagnosis can be made through history and physical examination, and imaging studies such as ultrasound, CT, and MRI can be useful in confirming the diagnosis 3, 4, 6.
Treatment and Management
- Treatment for iliopsoas tendinitis typically involves conservative measures such as activity modification, physical therapy, nonsteroidal anti-inflammatory drugs, and corticosteroid injections 2, 6.
- Surgical treatment may be considered in cases where conservative measures fail, and arthroscopic release of the iliopsoas tendon is a well-accepted surgical treatment for iliopsoas impingement 2, 5.
- Ultrasound-guided injection can be an effective diagnostic and therapeutic tool for iliopsoas tendinitis, and can provide significant improvement or complete resolution of symptoms in many cases 6.