Effect of acupuncture at " three points of ilioumbar" on lumbar function and pain in patients with iliopsoas muscle strain / 中国针灸

OBJECTIVE@#To compare the clinical effect of acupuncture at "three points of iliolumbar" combined with celecoxib and celecoxib alone in the treatment of iliopsoas muscle strain.@*METHODS@#A total of 60 patients with iliopsoas muscle strain were randomly divided into an observation group and a control group, 30 patients in each group. Celecoxib was given orally to both groups, 200 mg once a day for 3 days. On the basis of the above drugs, acupuncture was applied at (Extra), Wushu (GB 27), (Extra) in the observation group, once a day for 3 days. The Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) score were observed and compared before and after treatment, and the content of 5-hydroxytryptamine (5-HT) in serum was detected by enzyme-linked immunosorbent assay (ELISA) before and after treatment in the two groups.@*RESULTS@#After treatment, the JOA scores in the two groups were increased (both <0.05), and the VAS scores and 5-HT contents were decreased (all <0.05). The increase of JOA score in the observation group was greater than that in the control group (<0.05), and the decrease of VAS score and 5-HT content in the observation group was greater than that in the control group (both <0.05).@*CONCLUSION@#Acupuncture at "three points of ilioumbar" combined with celecoxib in the treatment of iliopsoas muscle strain can improve lumbar function, relieve pain and reduce 5-HT content in serum, which is better than celecoxib alone.

A Case of Myofascial Pain Syndrome of the Iliopsoas Muscle Undiagnosed for 3 Years with Chronic Abdominal Pain / 가정의학회지

Abdominal pain is one of the most common symptoms we encounter in primary care clinics, and the patients being hospitalized for abdominal pain account for 5-6% of all the inpatients. Careful history taking and physical exams are always necessary for the diagnosis of patients having abdominal pain, because their problems may be transient and insignificant but also can be severe. For the elderly patients, common causes of abdominal pain are unspecific abdominal pain, functional disease, constipation, kidney stone, urinary tract infection, inflammatory bowel disease, biliary tract disease, acute appendicitis, diverticulitis, abdominal aortic aneurysm, peptic ulcer, intestinal obstruction, mesenteric ischemia, malignant tumor, gastroenteritis, etc. and myofacscial pain can also be the cause. We treated an elderly female patient who had suffered severe abdominal pain due to myofascial pain syndrome of the iliopsoas muscle undiagnosed for over 3 years. Therefore we report this case with review of several literatures.

Patologias do compartimento iliopsoas: avaliação radiológica / Iliopsoas compartment lesions: a radiological evaluation

Limite posterior do retroperitônio, o compartimento iliopsoas localiza-se externamente ao mesmo, sendo composto dos músculos psoas maior, psoas menor e ilíaco. O quadro de sintomas dos pacientes com acometimento patológico deste compartimento é amplo e inespecífico, podendo haver importante atraso no diagnóstico. Entretanto, na busca do diagnóstico etiológico das alterações do compartimento iliopsoas, sabemos que as infecções, os tumores e as hemorragias respondem pela quase totalidade das lesões. Por meio da avaliação retrospectiva de exames radiológicos de pacientes com patologias do iliopsoas e que tiveram o diagnóstico confirmado por exame anatomopatológico ou acompanhamento clínico, revisamos a anatomia deste compartimento, assim como as suas principais formas de acometimento, identificando sinais que auxiliem na diferenciação dos potenciais diagnósticos diferenciais. Na abordagem de cada patologia discutiremos os principais sinais radiológicos, como a presença de gás em abscessos piogênicos, alterações ósseas em corpos vertebrais nas lesões secundárias a tuberculose, comprometimento dos planos fasciais nas lesões tumorais e diferenças na densidade e intensidade de sinal dos hematomas nas diferentes fases de degradação da hemoglobina, entre outros. Dessa forma, procuramos apresentar casos que exemplifiquem as doenças mais freqüentes do compartimento iliopsoas, destacando a importância dos seus diferentes sinais, aproximando-nos de um diagnóstico etiológico específico.

The iliopsoas compartment, a posterior boundary of the retroperitoneum, is comprised of the psoas major, psoas minor and iliac muscles. The symptoms picture in patients presenting with pathological involvement of this compartment may show a wide range of nonspecific clinical presentations that may lead to delayed diagnosis. However, in the search of an etiological diagnosis, it is already known that inflammation, tumors, and hemorrhages account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis.

Avulsion Facture of Short External Rotators in the Proximal Femur: A Case Report

Although avulsion fractures of greater and lesser trochanters rarely develop in hip fractures, avulsion fracture of short external rotators has not reported still online literature. Moreover, avulsion fracture of short external rotators can simulate the intertrochanteric fracture, and is difficult to differentiate from it on plain radiograph. This study is on the case 74-year old male patient who had avulsion fracture of short external rotators, and had the internal fixation with wire by open reduction under the diagnosis of the intertrochanteric fracture.

A Case of Spontaneous Retroperitoneal Hemorrhage due to Iliopsoas Muscle Hematoma in Patient with Myocardial Infarction Receiving Intravenous Heparin

The most common adverse effect of intravenous heparin is hemorrhage. Of the these, retroperitoneal hemorrhage and femoral neuropathy secondary to heparin anticoagulation has reported in 1966 for the first time by DeBolt and Jordan. We experienced a case of spontaneous retroperitoneal hemorrhage due to iliopsoas muscle hematoma in patient with myocardial infarction receiving intravenous heparin for a 3 days in therapeutic doses. The pathophysiology of iliopsoas muscle hematoma has not yet been cleared. But because of the possibility of large amount in volume, retroperitoneal hemorrhage has been known as a serious adverse effect that leads to the hypovolemic shock and death. In this article, we described the clinical manifestation, the importance of the early diagnosis and diagnostic clues and associated factors of the retroperitoneal hemorrhage in patient receiving intravenous heparin.