Clinical History 64 yo male with progressive anterior hip pain 1 year after hip replacement Ultrasound evaluation of the iliopsoas tendon was requested
Ultrasound of the Month – Case 80
1
Ultrasound of the Month – Case 80
2
Ultrasound of the Month – Case 80
3
Ultrasound of the Month – Case 80
4
Diagnosis: Iliopsoas Tendinosis due to impingement by acetabular cup after hip replacement Discussion The iliopsoas tendon is susceptible to irritation after ipsilateral hip replacement. Typical history is groin pain upon walking up and down stairs and getting out of a car. Iliopsoas tendinosis with or without iliopsoas bursal distension may be seen on ultrasound. The advantage of ultrasound is that direct impingement of the iliopsoas tendon by the acetabular cup may be visible; on MRI, susceptibility artifact from the metal can make evaluation of this area challenging. Ultrasound-guided injection of anesthetic and cortisone can be performed for diagnostic and therapeutic purposes. Under ultrasound, the needle can be placed safely adjacent to the iliopsoas tendon and iliopsoas bursal injection can be easily performed.
Ultrasound of the Month – Case 80
5