Iliopsoas

Gerrits, P. O. and Holstege, G. (1999) Descending projections from the nucleus retroambiguus to the iliopsoas motoneuronal cell groups in the female golden hamster possible role in reproductive behavior. J. Comp. Neurol. 403, 219-28. 

Westhoff B, Seller K, Wild A, et al. Ultrasound-guided botulinum toxin injection technique for the iliopsoas muscle. Dev Med Child Neurol. 2003 45 829-832. 

Hip OA is common in the elderly, with a characteristic presentation as shown in Table 90-3. However, pain located on the lateral hip typically represents trochanteric bursitis, while pain in the buttock region may indicate lumbar spine OA or iliopsoas bursitis. 

Muscle 30%-50% for most sites 70%-100% for thigh, iliopsoas, or nerve compression Risk of significant blood loss with femoral/retroperitoneal bleed bed rest for iliopsoas or other retroperitoneal bleeding... 

Tibialis anterior and extensor digitorum longus Gastrocnemius, soleus, and flexor hallucis longus Iliopsoas "... 

Fig. 9.1. Local muscle forces will displace fracture fragments. In the femur, the pull of iliopsoas will flex the proximal femur around the hip. Distally, gastrocnemius flexes the distal fragment at the knee.

Cantasdemir et al. (2003) reported their experience with CT-guided percutaneous drainage in 21 patients with iliopsoas abscesses, which were technically successful in 21/22 cases. Nineteen and three procedures were performed with the Trocar and Seldinger tech-... 

Cantasdemir M etal. (2003) Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas abscesses. Clin Radiol 58 811-815... 

The iliopsoas remains in constant activity in the erect posture and prevents hyperextension ofthe hipjoint in a standing subjeet. An increase in lumbar lordosis while standing erect causes increased activity of the psoas and low back instability and dysfunction. 

Somatic dysfunction of the lumbar region that is related to iliopsoas contracture usually occurs at the upper lumbar vertebral levels. 

The iliopsoas muscle also plays an important role in the synergistic activities of the muscles of the low back in maintaining a normal lumbosacral angle and proper postural balance. 

A major bony landmark is the greater trochanter, easily palpated on the lateral superior aspect of the shaft. The lesser trochanter is on the medial aspect of the inferior end of the femoral neck. This trochanter, although not palpable, is very important, because it is the site of attachment of the iliopsoas tendon. At its distal end, the femoral condyles and epicondyles are easily palpable at the knee joint. 

The iliopsoas muscle is often considered the "mainstay" in the column support system. It therefore has the potential for a significant role in the back pain of pregnancy and in back pain... 

Mrs. R. was admitted to labor and delivery and a normal spontaneous vaginal delivery was anticipated. Her first stage of labor was uneventful. She refused epidural anesthesia and reached full dilatation 4 hours after admission. During this phase of labor, her muscular back pain was treated with gentle myofascial stretching techniques. In general, obstetric patients in active labor tolerate these types of soft tissue techniques. However, as labor pain intensifies, patients may be unable to bear any manipulative treatment. This patient expressed relief of her muscular back pain but was unable to endure treatment of the sacrum and iliopsoas because of labor pain. 

As demonstrated in this case, the tension of the iliopsoas and restrictions found at the sacroiliac articulations may impede descent of the fetal head. Prolongation of this stage may very well result in maternal fatigue and the inability to deliver the child by usual means. If normal vaginal delivery is unfeasible, assistance with instrumentation, such as forceps or a vacuum extractor, may be attempted. The indications for vacuum assisted delivery include maternal exhaustion and inadequate expulsive efforts. Suction forces used with vacuum extraction range from 12 to 18 pounds per square inch. Further, vacuum extraction carries a risk of complication three times greater than normal vaginal delivery. 

Michele AA Iliopsoas. Springfield, MO Charles C. Thomas Publisher, 1962 187-189. 

Usually, the iliopsoas is the first and most affected of the hip muscles with a lesser degree of weakness in the glutei, hamstrings, and adductors as the disorder evolves in the lower hmbs. The quadriceps muscle remains strong (normal power or minimal reduction) despite the continuous weakening of all other proximal lower limb muscles and this feature is usually preserved through the course of the disease in most patients, even in wheelchair-bound or bedridden patients. This unique pattern of QSM is observed in the vast majority of patients with GNE mutations reported worldwide and facilitates the clinical recognition of this condition. However, in a minority of patients (less than 5% in the Middle Eastern cluster) the quadriceps may also become very weak even in the earlier phase of the disease [11, 14]. In other communities the quadriceps was sometimes reported to be "partially" spared. 

Gluteus medius, minimus, and tensor fascia lata Vastus lateralis and vastus intermedius Vastus medialis and vastus lateralis Tibialis anterior and extensor digitorum longus Gastrocnemius, soleus, and flexor hallucis longus Iliopsoas "... 

Yang WT, Yeo W, Metreweli C. (1999) Imaging of iliopsoas metastasis. Clin Radiol 54 85-89... 

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