Iliopsoas tendinopathy: snapping tendon

Case contributed by Dr Chris O'Donnell

Presentation

Sharp anterior right hip (groin) pain especially with flexion. Feels a "snap" in his groin as he flexes

Patient Data

Age: 20
Gender: Male

Lateral (iliacus) and larger medial (psoas) components of the ilio-psoas tendon cross the hip joint (anterior acetabulum) as separate structures prior to joining just proximal to the lesser trochanter insertion. Oedema in the muscle surrounding both of these tendons corresponding to the site of the patient's pain indicative of tendinopathy and adjacent muscle inflammation.

Case Discussion

The presence of separate medial and lateral tendons of iliopsoas is said to be a cause of "snapping" tendons whereby the medial (psoas) and lateral (iliacus) components cross over and impinge on the iliopectineal eminence during hip flexion and extension, causing the sensation of a snap.  Note how this causes irritation not so much to the tendons themselves that are minimally swollen in this case but mostly to the adjacent muscle fibres.

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Case information

rID: 51167
Case created: 6th Feb 2017
Last edited: 8th Feb 2017
Inclusion in quiz mode: Included

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