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At least 127 records · Page 7Linked to original sources
PubMed1983

[The role of the psoas muscle: apropos of the dissection of the muscles from 10 adults and 10 newborn infants].

The action of the iliopsoas muscle (Musculus iliopsoas) on movements of the hip is studied by direct traction on fresh cadavers (10 still-born and 10 adults). The psoas muscle is a powerful flexor of the hip but also an external rotator. The action of external rotation is moderate but obvious in every position of the femur (Os femoris) and more important if previously in abduction and internal rotation.

Adult↗
PubMed2005

Post-mortem redistribution of three beta-blockers in the rabbit.

To consider the role of the physico-chemical properties of drugs in their post-mortem redistribution, we designed the present study to investigate the influence of lipophilicity using an experimental rabbit model. Three beta-blockers (BB), atenolol, metoprolol and propranolol, with a similar dissociation constant (pK (a)) and increasing partition coefficient (K (p)) were administered intravenously to 18 rabbits. One hour after the last administration, the animals were killed by thiopental injection and placed in a supine position at room temperature. Autopsies were performed at 0, 2, 6, 12, 24 and 48 h post-mortem. Concentrations of the three BB were determined in fluids (right and left cardiac blood, peripheral blood, urine, bile, stomach content, vitreous humour) and tissues (cardiac muscle, lungs, liver, brain, diaphragm, iliopsoas muscle) using a previously published, validated liquid chromatography-electrospray-mass spectrometry method. Our results show that lipophilicity influences post-mortem redistribution of the molecules in a certain number of anatomical sites such as the stomach, lungs, cardiac muscle, cardiac blood or liver, but does not appear to intervene in other sites such as the brain or the vitreous humour.

Adrenergic beta-Antagonists↗
PubMed2000

[An adult case of recurrent myelopathy presenting with monoplegia following asthmatic attacks].

A 22-year-old woman noticed an acute onset muscle weakness in her right leg after an asthmatic attack. A neurological examination showed moderate muscle weakness from the right iliopsoas muscle to the toe muscles, a decreased deep tendon reflex in her right lower limb and mild hypesthesia in her right L2-S1 segments. Needle EMG revealed fibrillation potentials in the right gastrocnemius muscle and a positive sharp wave in the right anterior tibialis muscle. The findings of motor nerve conduction studies and sensory nerve conduction studies were normal. The lesion was considered to be located at the posterior horns, as well as at the anterior horns at the L2-S1 levels and also at their roots on the right side. The anterior horn cells appeared to be the most severely affected. Polio-, echo-, entero- and coxsackie-virus antibody titers showed no significant changes on the 36th and 64th days of the disease. The serum IgE level was elevated and mite antigen-specific IgE was strongly positive. MRI revealed no abnormalities in either the thoracic or lumbar spinal cord. Although the sensory disturbance did rapidly improve after corticosteroid therapy, no improvement was seen in her muscle weakness which thus resulted in the atrophy of the affected muscle. While undergoing the corticosteroid therapy, she suffered another asthmatic attack. Nine days after the second attack, she further developed weakness in her right deltoid, biceps brachii, triceps brachii, wrist extensor, wrist flexor, digits extensor and digits flexor muscles with hyperreflexia in her left upper limb. Cervical MRI disclosed a high intensity area at the C3-6 level on the T2-weighted images and also a gadolinium enhancement of the lesion. Since monoplegia had appeared twice previously after bronchial asthma attacks in this case, Hopkins syndrome was suggested. Hopkins syndrome has so far been exclusively reported in children, and no recurrent cases have ever been reported with this condition. This is therefore considered to be the first case of Hopkins syndrome occurring in an adult and also demonstrating recurrence.

Adult↗
PubMed1995

Caudal medullary pathways to lumbosacral motoneuronal cell groups in the cat: evidence for direct projections possibly representing the final common pathway for lordosis.

The nucleus retroambiguus (NRA) projects to distinct brainstem and cervical and thoracic cord motoneuronal cell groups. The present paper describes NRA projections to distinct motoneuronal cell groups in the lumbar enlargement. Lumbosacral injections of wheat germ agglutinin-horseradish peroxidase (WGA-HRP) were made to localize and quantify the retrogradely labeled neurons in the caudal medullary lateral tegmentum. These injections were combined with spinal hemisections to distinguish between neurons having ipsi-or contralaterally descending axons. The NRA-lumbosacral fibers descend almost exclusively contralaterally, but neurons in areas surrounding the NRA project mainly ipsilaterally. In an anterograde tracing study, injections of WGA-HRP or tritiated leucine were made in the region of the NRA to determine the NRA targets in the lumbosarcral cord. Hemisections in C2 made it possible to distinguish between NRA projections and projections from neurons in the adjoining lateral tegmentum. The results show delicate NRA projections to distinct lumbosacral motoneuronal cell groups innervating specific hindlimb muscles (iliopsoas, adductors, and hamstrings) as well as axial muscles (medial longissimus and proximal tail muscles). The projection is bilateral, with a contralateral predominance. Ipsilaterally terminating fibers are derived from NRA neurons whose axons cross the midline at the level of the obex, descend through the contralateral spinal white matter, and recross at the level of termination. A conceptual description is presented in which the periaqueductal gray-NRA-lumbosacral projections form the final common pathway for lordosis in the cat.

Animals↗
PubMed2000

Complications of Chiari and Salter osteotomies: a cadaver study.

Previous investigations of the Chiari and Salter osteotomies showed that intraoperative vessel and nerve injuries are described repeatedly in the case of both pelvic osteotomies. The aim of our investigations was the exposure of each operation step in anatomic specimens to show the anatomic landmarks and potential risks. We performed nine Chiari osteotomies and five Salter osteotomies on formalin-fixed cadavers. The operation steps were made consecutively to assess the risks to the vessels and nerves as well as the determination of anatomically important reference points. In both procedures an injury of the lateral femoral cutaneous nerve at the anterior access route is feasible. By ensuring that the skin including the lateral femoral cutaneous nerve is pulled medially, injury can be avoided. Additionally, too long retraction of the tensor fasciae latae muscle injures its nutrient vessels. An inadequate subperiosteal approach during the pull on the Hohmann's retractor leads to crushing and irritation of the sciatic nerve. Moreover, there is a risk that the superior gluteal nerve as well as the superior gluteal artery may be injured. An inadequate subperiosteal application of the medial Hohmann's retractor can endanger the obturator nerve. In the Chiari osteotomy there is a risk of injury to the articular branch of the superior gluteal nerve, which supplies parts of the ventral hip joint capsule. By inserting the K-wire too far medially the internal oblique muscle is endangered. Too prolonged retraction of the iliopsoas muscle in a Salter osteotomy can lead to compression of the femoral nerve. The form of the osteotomy has an influence on the stability of the hip joint in the course of exposure of the hip joint. On account of the narrow spatial connection between the anatomic pathways and the osteotomy area, strict subperiosteal dissection and careful use of the retractor are essential to avoid nerve and vessel injuries.

Aged↗
PubMed1989

Femoral neuropathy: the role of computed tomography in diagnosis and management in 27 patients.

The computed tomography findings in 27 patients with an ultimate diagnosis of femoral neuropathy were reviewed. Haemorrhagic disorders were responsible for the neuropathy in 10 patients, neoplasia in eight, infection in five and in the remaining four patients no abnormality was noted on CT and the aetiology remained uncertain. Unilateral enlargement of the iliopsoas muscle or a soft tissue mass involving the iliopsoas compartment was noted in the 23 patients with positive studies. The exact nature of the mass could not be determined by CT alone, but, when considered together with clinical history and examination, a definitive diagnosis was possible in most instances. Whenever necessary, percutaneous needle biopsy or drainage was performed. Computed tomography should be performed at an early stage in all patients suspected of femoral neuropathy. It accurately demonstrates and delineates retroperitoneal masses causing this condition and allows further definitive diagnostic procedures such as biopsy or drainage to be performed when necessary.

Adolescent↗
PubMed1992

[A direct approach and a crease-resistant prosthesis: two simplifications of subperitoneal hernioplasty].

With experience of six already known techniques, the authors have developed a personal procedure combining three main principles: 1) large and direct exposure of the preperitoneal space, 2) the mesh, supple but not soft, needing no fixation, 3) outline of this mesh adapted to the concave shape of the pelvic wall, and avoiding the risk of a ventral hernia. The original points of this technique are the following: approach along the lateral border of the rectus muscle through its sheath, the initial exposure of the iliopsoas muscle and retropubic space, and the cutting of the mesh extending far beyond the borders of the inguinal and femoral orifices, with a flap reinforcing the posterior aspect of the rectus muscle. One hundred and two consecutive patients (173 hernias, 48 recurrences) were operated upon, and all but two were followed for a mean period of 36.8 months. Morbidity was low, with no prosthesis infection, and there was no recurrence or incisional hernia. The authors emphasize the simplicity and the rapidity of this technique, without advocating it as a routine operation, since it carries, like all prosthetic techniques, the potential for sepsis and preperitoneal fibrosis.

Adult↗
PubMed1994

[Therapeutic and functional electrical stimulation for paraplegics].

The first objective of this study was to compare the cross-sectional areas of muscles and muscle force before and after 6 months of therapeutic electrical stimulation (TES) by using computed tomography (CT), Cybex II, a strain-gauge, and manual muscle test (MMT) in 5 complete paraplegics. The stimulation parameters were a frequency of 20 Hz, a pulse width of 0.2 ms, and an output voltage of -15V. The cross-sectional areas of muscle, the CT numbers, and both the muscle torque and the muscle force increased after TES, but the initial muscle force need to have been greater than a poor-minus level on MMT in order to achieve practical benefits from TES. Therefore TES should be started as early as possible after the onset of paraplegia in order to maintain and improve muscle quality. The second objective of this study was to re-chart the electrical stimulation used for reconstructing the standing-up motion in paraplegics. Twelve healthy subjects were monitored during two different kinds of standing-up motion: 1) standing-up while the arms remained crossed in front of the chest, and 2) hands-assisted standing-up using parallel bars. The electromyogram, joint angle, and the vertical component of the floor reaction force were synchronized with time, and investigated. The main muscles for standing-up are the quadriceps, the tibialis anterior, and the paraspinal muscles. Comparing 1) and 2), the hands-assisted standing-up was performed with less muscle activity except for the rectus femoris and the iliopsoas muscle, and with less maximum vertical floor reaction force. A T6 paraplegic patient could stand-up smoothly from a wheel-chair using the parallel bars after electrical stimulation based on data from the hands-assisted standing-up study on healthy subjects. In comparison with healthy subjects, the knee joints initially flexed before extending, and the ankle joints were more dorsiflexed in the paraplegic patient. The maximum vertical floor reaction force was also less.

Adult↗
PubMed1999

[Limb preservation after clostridial myonecrosis following internal fixation of a closed femoral fracture].

A 24-year-old healthy man developed Clostridium perfringens myonecrosis with severe sepsis after plating of a closed femoral fracture. The leg could be preserved by complete resection of the fascia from all muscle compartments of the leg, including the pelvitrochanteric and the iliopsoas muscles, radical removal of necrotic muscle tissue, dissection of the para-aortal infrarenal lymphatics, daily débridements over 2 weeks, and systemic antibiotic therapy. The plate was removed because of a second septic episode followed by temporary stabilization with external fixation. After soft-tissue healing, plate fixation was carried out. The patient developed significant deficit of knee flexion (0 degree/0/20 degrees) due to heterotopic ossification of the quadriceps femoris muscle that could be improved by partial resection of heterotopic bone formation. In the same operation the bony defect of the femur was filled with autologous bone graft. The fracture healed 10 months after the accident. The patient can work full time in his previous profession as a mechanic, but again needs operative mobilization of the knee joint, including open arthrolysis and quadriceps plasty.

Adult↗
PubMed2001

An elderly patient with gastric carcinoma developing multiple metastasis in skeletal muscle.

We present a 70-year-old man with gastric carcinoma developing multiple metastasis in skeletal muscle. He had a right supraclavicular lymph node swelling. Brain, chest and abdomen CT scans revealed metastatic lesions in the brain, lung, liver and bilateral adrenal glands. Further, CT showed a ring enhanced soft-tissue mass in the left lumbar muscle. Needle aspirate of the mass in both the left lumbar muscle and the right enlarged supraclavicular lymph node revealed cells suggestive of poorly differentiated adenocarcinoma. Upper gastrointestinal endoscopic evaluation demonstrated an advanced gastric carcinoma. Two months after admission, the tumor in the left lumbar muscle had grown and some new lesions in the left iliopsoas muscles appeared. Intramuscular metastasis from gastric carcinoma is an extremely rare phenomenon.

Adenocarcinoma↗
PubMed2004

[Pravastatin-associated polymyositis, a case report].

A 69 year old man complained of general myalgia, arthralgia and muscle weakness in two weeks after he started to take 10 mg per day pravastatin. Symptoms progressed at least for 3 months after withdrawal of the medication. The muscle weakness was more in distal upper extremities and the iliopsoas muscle. Serum CK was 943IU/L. The anti-nuclear and Jo-1 antibody were positive. EMG examinations disclosed fibrillation potentials at rest and myopathic discharges by a voluntary contractor. Symptoms as well as serum CK values improved promptly by treatment with prednisolone. From these clinical and laboratory results, it was speculated that this patient suffered from subacute polymyositis, although pathological studies were not performed. Because of continuing hypercholesterolemia, the patient was retreated with atorvastatin, presenting similar, but less serious symptoms. So far, three cases of statin-associated polymyositis or dermatomyositis were reported. Statins could influence the immune system, but it is still unsettled if statins cause autoimmune polymyositis. This problem warrants further study.

Aged↗
PubMed1985

Iliopsoas injury in soccer players.

Injuries to the iliopsoas muscle are rarely mentioned in the literature dealing with soccer-related trauma. This report describes our experience in the successful diagnosis and treatment of iliopsoas injury in 40 professional soccer players. These injuries were not associated with direct external trauma to the muscle. Anatomical and functional characteristics of the iliopsoas are reviewed as they relate to the diagnosis and to the treatment by direct local injection with corticosteroids. A safe anatomical approach to the iliopsoas below the inguinal ligament is described.

Adrenal Cortex Hormones↗
PubMed2000

Effects of a three-month therapeutic exercise programme on flexibility in subjects with low back pain.

BACKGROUND AND PURPOSE: Spinal and muscle flexibility have been studied intensively and used clinically as outcome measurements in the rehabilitation of subjects with low back pain. The results of previous studies are contradictory and there is a lack of longitudinal data on the effects of long term therapeutic exercise on flexibility. METHOD: A controlled experimental study was conducted to determine the effects of progressive therapeutic exercise on spinal and muscle flexibility. Eighty-six chronic low back pain subjects fulfilled the inclusion criteria and were divided into three study groups: (1) intensive training group, (2) home exercise group and (3) control group. The intervention period lasted three months and measurements were performed at both the beginning of the study and immediately after intervention. Follow-up measurements were carried out six and 12 months after baseline. Spinal flexibility was measured with lumbar flexion, extension, spinal lateral flexion and rotation, and muscle flexibility was measured with measurements of erector spinae, hamstring and iliopsoas muscles. Also self-reported outcomes of the Oswestry Index and Borg Scale--Back Pain Intensity were used. Associations between change (pre- to post-treatment) were determined for the dependent variables. RESULTS: The results showed no correlation between flexibility, the Oswestry Index or back pain intensity. After the first three-month period lumbar flexion, extension and spinal rotation decreased among all subjects. Spinal rotation and erector spinae muscle flexibility improved significantly with intensive training. At the nine-month follow-up, erector spine flexibility was still greater than at baseline. Hamstring flexibility increased among the intensive training and home exercise groups from pre- to post-intervention. However, the degree of hamstring flexibility gained during training was subsequently lost following the period without programmed exercise in both training groups. Self-reported outcome variables showed positive changes among the three study groups after the completion of intervention period, but these changes were only able to be maintained during subsequent follow-ups for the intensive training and home exercise groups. CONCLUSIONS: The findings suggest that flexibility does not play an important role in coping with chronic low back pain for subjects whose functional limitations are not severe. Also, it appears that the achieved gains in spinal and muscle flexibility may not be able to be maintained without continued exercise.

Case-Control Studies↗
PubMed1984

The snapping iliopsoas tendon.

Herein we describe a previously seldom recognized variety of snapping hip, which is caused by snapping of the iliopsoas tendon over the iliopectineal eminence when the femur is moved from the flexed position at the hip and extended through 45 degrees of flexion. The finding is demonstrated with the patient supine and gently resisting gravity with the iliopsoas muscle, thus placing it under tension. At approximately 45 degrees of flexion, the iliopsoas tendon in two patients was confirmed radiographically to snap abruptly, coincident with an audible sound over the iliopectineal eminence of the pelvis. We believe that this occurs relatively frequently and is generally asymptomatic.

Adult↗
PubMed1996

Iliopsoas haematoma in an adolescent Taekwondo player.

A 16-year-old male Taekwondo player was admitted with a 1-day history of right groin pain and a palpable mass in the right lower abdominal quadrant following a Taekwondo training session. No history of direct trauma was given, but the pain followed a high inward-to-outward kick. The patient was not on any medication, and tumour and infection were excluded. A high-resolution real-time ultrasound scan identified a well-defined, hyperechoic, heterogeneous mass in the substance of the right iliopsoas muscle, compatible with a collection of partially clotted blood, confirming the clinical diagnosis of iliopsoas haematoma. After conservative treatment the patient resumed training and is now fully asymptomatic.

Adolescent↗
PubMed1990

[Dysfunction of the femoral nerve caused by hemorrhage in anticoagulant use].

Femoral neuropathy resulting from iliopsoas muscle haematoma during anticoagulant therapy is described with reference to five patients. The clinical picture is stereotypic. The patient experiences sudden, excruciating pain in the inguinal area and flank radiating to the anterior section of the thigh. This is followed by weakness of the quadriceps muscle. Computed tomography is the method of choice to show the presence of an iliopsoas haematoma. To prevent serious and sometimes irreversible nerve damage the anticoagulant therapy should be stopped and antagonists should be given. Surgical decompression of the haematoma has been advocated, but this intervention has been done only in a few patients.

Aged↗
PubMed2002

Giant iliopsoas bursitis: sonographic findings with magnetic resonance correlations.

We present the case of a 40-year-old man with rheumatoid arthritis who had a painless left inguinal mass. Sonographic examination revealed a large soft tissue mass with mixed internal echotexture and regular borders extending inside the pelvis and into the proximal portion of the thigh. Sonography also showed communication between the bursa of the iliopsoas muscle and the hip cavity, with intra-articular synovitis and erosion of the ileum. Giant iliopsoas bursitis secondary to hip involvement in rheumatoid arthritis was diagnosed on the basis of the sonographic findings. This diagnosis was confirmed by MRI.

Adult↗
PubMedDate not supplied

Psoas haematoma and femoral neuropathy associated with enoxaparin therapy.

Haemorrhage into the iliopsoas muscle causing femoral neuropathy is an infrequent complication of haemophilia or anticoagulant therapy. The association of an iliopsoas haematoma with enoxaparin therapy is very rare. We describe a case of femoral neuropathy secondary to psoas haematoma in a patient who was on enoxaparin therapy for suspected non-Q wave myocardial infarction. There is no clear consensus for the treatment of these haematomas, with both surgical and conservative options advocated. In this case, our patient recovered fully following conservative management.

Adult↗