Keywords:
Musculoskeletal spine, Neuroradiology spine, Musculoskeletal soft tissue, MR, Imaging sequences, Normal variants, Statistics, Pathology, Hernia, Inflammation
Authors:
C. Ottonello1, V. Tempesta2, A. Giardino1, C. Messina3, L. Giuliani1, P. Giuliani1; 1Rome/IT, 2Frascati/IT, 3Milan/IT
DOI:
10.1594/ecr2018/C-2519
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 region when sitting or particularly when changing positions arising for sitting to standing,
difficulty when trying to stand in a fully erect posture,
groin pain,
radiation of pain down the leg and limping.
Physical examination is very important in diagnosis and Thomas test is very useful: the patient lies supine on the examination table and holds the uninvolved knee to his or her chest,
while allowing the involved extremity to lie flat; holding the knee to the chest flattens out the lumbar lordosis and stabilizes the pelvis.
If the iliopsoas muscle is shortened,
or a contracture is present,
the lower extremity on the involved side will be unable to fully extend at the hip: this constitutes a positive Thomas test. Sometimes,
with a very flexible patient,
the Thomas test will be normal despite a psoas dysfunction being present.
However,
in the patient with a normal hip joint,
a positive test is a good indicator of psoas hypertonicity.
It is very important to consider this condition as part of the differential diagnosis for patients presenting with low back pain.
Aim of our study is to identify any MRI finding that could be correlated with psoas syndrome (PS),
especially in the cases of chronic low back pain without evidence of hernias,
arthrosis or other causes of pain