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HSS J. 2013 Oct;9(3):236-41. doi: 10.1007/s11420-013-9361-9. Epub 2013 Aug 21.

MR Appearance and Clinical Significance of Changes in the Hip Muscles and Iliopsoas Tendon After Arthroscopic Iliopsoas Tenotomy in Symptomatic Patients.

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1
Department of Radiology, University of Wisconsin, 600 Highland Avenue, Madison, WI 53705 USA.
2
Department of Orthopedics, University of Wisconsin, 600 Highland Avenue, Madison, WI 53705 USA.

Abstract

BACKGROUND:

Iliopsoas tenotomy is a treatment for snapping hip. Does this surgical procedure change the surrounding muscle and tendon anatomy?

QUESTIONS/PURPOSES:

This study seeks to evaluate the changes in the MR appearance of the hip muscles and iliopsoas tendon in patients following arthroscopic iliopsoas tenotomy.

METHODS:

One hundred sixty-nine consecutive adults were evaluated after iliopsoas tenotomy at the lesser trochanter. Each MR exam was evaluated independently by three radiologists for muscle edema, atrophy (grade 0-4), compensatory hypertrophy, signal within the iliopsoas tendon (increased on T1 or T2 sequences), and iliopsoas tendon morphology (distorted or disrupted) above, at, and below the iliopectineal eminence. A finding was considered positive if reported by two or three of the radiologists.

RESULTS:

Twenty subjects met the inclusion criteria. Muscle edema was present in 15% (3/20) of subjects within the iliacus, psoas, and quadratus femoris. Atrophy was observed in the following muscles: iliacus 85% (17/20), psoas 75% (15/20), quadratus femoris 10% (2/20), rectus femoris 5% (1/20), vastus lateralis 5% (1/20), and gluteus maximus 25% (5/20). There was no compensatory hypertrophy. Ninety percent (18/20) had increased T1 and 10% (2/20) had increased T2 signal within the iliopsoas tendon. Thirty-five percent (7/20) of the iliopsoas tendons was disrupted and 85% (17/20) was distorted, most commonly below the iliopectineal eminence.

CONCLUSION:

The majority of postoperative symptomatic patients has atrophy of the iliacus and psoas muscles and distortion and disruption of the iliopsoas tendon and should be recognized as a normal imaging appearance following iliopsoas tendon release.

KEYWORDS:

iliopsoas; muscle atrophy postoperative; tenotomy

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