Abstract
ObjectiveThe variation in the anatomy of the iliopsoas tendon is important information for orthopaedic surgeons operating around the hip. The aim of this study was to identify the prevalence of bifid iliopsoas tendons in children on magnetic resonance imaging (MRI).MethodsMRI hip and pelvis images of 50 sequential children aged 7–15 years were retrieved from our radiology database at the Evelina London Children’s Hospital from 2007 to 2013. Included were 37 children with imaging of both hips and 13 children with imaging of one hip only. Therefore, our study was based on a total of 87 hips.ResultsAt least 1 bifid tendon was noted in 13 children (26 %). Five children from a total of 37 (14 %) with both hips adequately imaged had bilateral bifid tendons. Among all 87 adequately imaged hips, 18 (21 %) were found to have two discrete distal iliopsoas tendons.ConclusionsBifid iliopsoas tendon is noted anecdotally by surgeons but was only reported in scattered case reports and a few anatomical studies until very recently. Our finding is that a bifid iliopsoas tendon with two distinct tendinous components at the level of the hip joint is quite common. This has clinical significance, particularly in children’s orthopaedic surgery when an adequate iliopsoas release is important.
Highlights
The iliopsoas tendon is the conjoint tendon of the psoas major and iliacus muscles
The aim of this study was to identify the prevalence of bifid iliopsoas tendons in children on magnetic resonance imaging (MRI)
Our hypothesis was that a bifid tendon is more common than previously reported, so the aim of this study was to identify the prevalence of bifid iliopsoas tendons visible on MRI in children
Summary
The iliopsoas tendon is the conjoint tendon of the psoas major and iliacus muscles. The psoas major—a long, fusiform muscle—originates from the transverse processes of the lumbar vertebrae and runs caudally across the brim of the pelvis to lie anterior to the hip capsule before inserting into the lesser trochanter of the femur. In children with cerebral palsy and other neuromuscular conditions, contractures of the iliopsoas, and other muscles, are common. This is due to disuse, muscular imbalance or spasticity. The iliopsoas tendon has been implicated as a generator of hip pain and a cause of labral injury due to impingement [10]. The two bony structures commonly implicated are the anterior aspect of the femoral head and the joint capsule and the iliopectineal eminence of the pelvic brim [11,12,13] It has been described as a source of pain following total joint replacement [14]. Our hypothesis was that a bifid tendon is more common than previously reported, so the aim of this study was to identify the prevalence of bifid iliopsoas tendons visible on MRI in children
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