2017 ISAKOS Biennial Congress ePoster #506
Athletic Iliopsoas-Related Groin Pain: Comparing Cause and Prevalence Between Muscle Strain Type and Peritendiniis Type
Shoichiro Imamura, MS, Saitama, Saitama JAPAN
Sadao Niga, MD, PhD, Saitama, Saitama JAPAN
Tadahiro Nihei, Saitama, Saitama JAPAN
Yosuke Suzuki, MS, Saitama, Saitama JAPAN
Kaoru Suzuki, Saitama, Saitama JAPAN
Jindou Hatanaka, Kawaguchi, Saitama JAPAN
Masayoshi Saito, MD, Tokyo, Chuo-ku JAPAN
Sachiyuki Tsukada, MD, PhD, Mito, Ibaraki JAPAN
JIN Orthopedic & Sports Clinic , Saitama, Saitama, JAPAN
FDA Status Not Applicable
Consecutive 134 athletes having signal intensity change in iliopsoas on MRI were classified into muscle strain type (massive lesion in muscle belly, n = 69) and peritendinitis type (long and thin lesion along tendon, n = 65). Because only 20 % and 32 % of athletes had clear trauma history in muscle strain type and peritendinitis type, respectively, MRI could help confirm a diagnosis.
For athletic iliopsoas-related groin injury, we classified signal intensity change in iliopsoas on short time inversion recovery magnetic resonance imaging (MRI) into two types: muscle strain type and peritendinitis type. The aim of this study was to investigate the cause and prevalence of these two types of athletic iliopsoas-related groin injury.
This study included the consecutive 134 athletes had high signal intensity in iliopsoas on short time inversion recovery (STIR) MRI between May 2013 and February 2016 (28 women and 106 men, with a mean age of 18 years). Muscle strain type was defined as that there was massive high signal area in muscle belly of iliopsoas with clear border, and peritendinitis type was defined as that there was long and thin high signal area upward along iliopsoas tendon without clear border. The sports, level of play, groin pain duration at the MRI study, and cause of iliopsoas injury were investigated. We compared the sports, rate of trauma history, and the cause of iliopsoas injury between types. In addition, we investigated the prevalence of iliopsoas muscle strain type and peritendinitis type in the all groin injury athletes during study period.
69 athletes were classified to muscle strain type, and 65 to peritendinitis type. The predominant sports was soccer in two groups (64 % in muscle strain type and 68 % in peritendinitis type). Only 14 athletes (20 %) and 21 athletes (32 %) had clear trauma history in muscle strain type and peritendinitis type, respectively. Between two types, there were no significant differences in terms of the rate of having clear trauma history and the cause of injury (p = 0.11). 54 athletes (78 %) and 51 athletes (78 %) could be identified the cause of injury in muscle strain type and peritendinitis type, respectively. The identified causes of iliopsoas injury were excess abdominal muscle exercise (n = 40), dash exercise using stairs /rising slope or excess thigh-up exercise (n = 30), kicking exercise for long distance (n = 22), medical history related-injury (n = 12), and others (n = 18). The rate of each cause was not significantly different between types. Of 638 groin injury athletes during study period, the numbers of iliopsoas muscle strain and iliopsoas peritendinitis were 69 (11 %) and 65 (10 %), respectively.
Because distinguishing muscle strain type and peritendinitis type was difficult based on the absence of trauma history or the cause of injury, MRI was useful to distinguish the type of iliopsoas injury.