China
Africa
Explore chapters and articles related to this topic
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Incidence of femoral neuropathy in parturients has considerably declined with modern obstetric care. Branches of the lumbar plexus (L2–4) do not enter the true pelvis; the compression of femoral nerve therefore usually occurs at the inguinal ligament due to prolonged lithotomy position (29). Findings include difficulty walking and knee buckling, weakness of quadriceps femoris, absent patellar reflex, and impaired sensation in saphenous nerve distribution. Weakness of iliopsoas when present indicates a more proximal lesion due to nerve stretch from abduction and external rotation of hip or injury from instrumentation. Proximal part of femoral nerve has poor blood supply and is also prone to ischemia. Prognosis is favorable in majority of patients consistent with neurapraxic injury.
Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Jocelyn A. Luongo, Boris Shapiro, Orlando A. Ortiz, Douglas S. Katz
Signs/symptoms are, as noted, often non-specific, and unanticipated iliopsoas abscess may be identified on CT. The CT findings of psoas abscess include enlargement of the muscle by a low-attenuation mass, which displays rim enhancement after IV contrast administration. Other findings include obliteration of normal fat planes, as well as adjacent bone destruction and gas formation. Gas within a psoas abscess may also be related to an underlying bowel fistula, such as in Crohn disease or diverticulitis. MRI is the most sensitive modality to look for infectious/inflammatory changes in the adjacent bone and cartilage, and is particularly helpful if there is concern for associated discitis, osteomyelitis, or sacroiliitis. Increased signal on fluid-sensitive sequences within muscle, however, is not specific for a psoas abscess, and may be due to a primary pathologic process in the spine causing muscle edema. Abnormal uptake on a Ga-67 scan may also be used for diagnosis, although other entities, such as lymphoma, also show increased uptake; this finding is therefore not specific. CT-guided percutaneous drainage is the primary treatment of choice for iliopsoas abscesses, and it also helps to exclude alternative diagnoses and to guide targeted antibiotic therapy [12–21].
Salter's osteotomy and Dega osteotomy
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Next, the medial portion of the capsule is exposed, again using the periosteal elevator to dissect between the capsule and the iliopsoas tendon. Flexion of the hip relaxes the iliopsoas and provides good medial exposure.
Imaging changes following surgery for ischiofemoral impingement
Published in Baylor University Medical Center Proceedings, 2023
Munif Hatem, Richard Feng, Jordan Teel, Hal David Martin
Atrophy of the iliacus and psoas muscles has been reported following iliopsoas tenotomy in association with hip arthroscopy.11,12 However, these studies reported no significant difference in the mHHS relative to the amount of atrophy.11,12 In the present study, no correlation between the mHHS and the amount of iliopsoas atrophy was observed. The primary function of the iliopsoas muscle is hip flexion, and tenotomy or detachment from the LT could result in hip flexion weakness. In the present study, one patient reported hip flexion weakness in the early postoperative period, which was resolved at 4-month follow-up. Previous studies have reported improvement of hip flexor weakness by at least 8 weeks postoperatively after iliopsoas tendon release.13,14 Brandenburg et al reported a 19% reduction in seated hip flexion strength following iliopsoas tenotomy at the level of the hip joint.15 Those authors also reported no significant difference in hip flexion strength in the supine position when comparing the operated with the nonoperated side.15 The reinsertion of the iliopsoas onto the femur following the LT resection could prevent flexor weakness. While the technique for iliopsoas reinsertion following LT resection is published, clinical results on hip flexor strength are not reported.16
Effects of backrest and seat-pan inclination of tractor seat on biomechanical characteristics of lumbar, abdomen, leg and spine
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Qichao Wang, Yihuan Huo, Zheng Xu, Wenjie Zhang, Yujun Shang, Hongmei Xu
In this study, the muscles with high activities, including gluteus maximus, semitendinosus, Rectus femoris, iliopsoas, vastus lateralis and sartorius, were analyzed, and those muscles with low activities or small muscle tissues were not taken into account. Gluteus maximus has a wide and thick quadrilateral shape, and mainly drives the extension and external rotation of the thigh. Semitendinosus is located at the back of the thigh and helps the extension of the hip joint and bending of the knee joint. Rectus femoris is located in the front of the thigh, whose main function is to extend the knee joint and bend the thigh. Iliopsoas is composed of psoas major muscle and iliacus, which is mainly responsible for the external rotation of the thigh and forward flexion of the pelvis and trunk. The sartorius is flat and banded, and is one of the longest in the leg muscles, starting from the anterior superior iliac spine, passing through the inner side of the knee joint, and finally to the inner side of the upper end of the tibia. The main function of sartorius is for the bending of the hip and knee.
Physical therapy management of a patient with persistent groin pain after total hip arthroplasty and iliopsoas tenotomy: a case report
Published in Physiotherapy Theory and Practice, 2022
Strengthening exercises were prescribed for the hip abductors and external rotators were prescribed because of the patient’s poor strength and stability in the right hip. Exercises to improve the strength of remaining hip flexor muscles were also prescribed. Despite exercises to improve hip flexion strength, weakness in hip flexion remained at discharge. Because the iliopsoas is the primary flexor of the hip, weakness in hip flexion is an expected outcome of iliopsoas tenotomy and is sacrificed to reduce the patient’s pain (Thaunat et al., 2018). There is little evidence informing the clinical management of patients with femoroacetabular impingement syndrome, who often have similar presentations to the patient in this case (Enseki et al., 2014). The current clinical practice guidelines for nonarthritic hip joint pain give all interventions an “F” grade, indicating evidence exists only at the expert-opinion level (Enseki et al., 2014). A retrospective case series by Johnston, Lindsay, and Wiley (1999) indicated a positive effect of hip rotation exercises in patients with iliopsoas syndrome. Similar exercises were used in the current case.