Aims and objectives
Psoas syndrome (PS) diagnosis is essentially based on symptoms and clinical findings and frequently missed.
Frequently PS is due to a muscular dysfunction,
but also morpho-physiological changes are possible (e.g.: short and/or tight psoas).
Other causes include muscular overstretching and muscular strain.
PS can cause a variety of symptoms,
including pain in the lumbosacral regionwhen sitting or particularly when changing positions arising for sitting to standing,
difficulty when trying to stand in a fully erect posture,
radiation of pain down the leg and...
Methods and materials
From june 2016 to june 2017 we performed lumbar spine MRI in 1040 patients (590 males,
mean 55,5 ± 12,2): sagittal T1-T2,
T2 fat suppressed WI,
axial T2 WI.
as possible PS MRI finding,
any vertebral rotation in lumbar spine,
particularly on L1 and L2 ("key disfunction"),
but also on L3-L5 (contralateral rotation) and psoas trophism,
morphology and signal behaviour.
Patients with PS findings underwent clinical examination.
In 203/1040 (19,5%) we found L1-L2 rotation with L3-L5 contralateral rotation,
in 351/1040 (33,7%) psoas trophism asymmetry,
in 141/1040 (13,5%) psoas hypotrophy,
no significant psoas alterations in morphology and signal behaviour.
Patients with vertebral rotation and/or psoas trophism asymmetry without hernias,
arthrosis or other causes of radiculopathy (97/1040,
underwent physical examination that showed PS clinical findings in 80/97 (82%).
Although clinical examination is crucial in PS diagnosing,
MRImay be able to suspect PS and to provide a valid morphological support to physical tests.
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