Ilio-psoas hematoma--its detection, and treatment with special reference to hemophilia.

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Pain around the hip joint and femoral neuropathy in a patient with a bleeding coagulopathy should alert the physician to the possibility of an iliopsoas haematoma. Unfortunately this diagnosis is often missed. Clinically, reduced hip motion, a mass in the iliac fossa and alteration in the motor and sensory function of the femoral nerve may be noted. If the pain is on the right side, appendicitis must be excluded. Ultrasound is the diagnostic aid of choice, being more sensitive than computerized tomography or radioisotope investigations. Treatment should be gradual, gentle and protracted to avoid recurrent bleeding episodes.