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Diagnostic and Therapeutic Use of Sonography-Guided Iliopsoas Peritendinous Injections

Ronald S. Adler1, Robert Buly2, Regina Ambrose1 and Thomas Sculco2

1 Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th St., New York, NY 10021.
2 Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021.



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  		Fig. 1 —Axial image of iliopsoas tendon at level of joint line in 19-year-old man. Fast spin-echo proton density image (left) and corresponding sonogram (right) show anatomic relationship of iliopsoas tendon (arrow), femoral head (F), and iliopectineal eminence of acetabulum (A). Tendon (arrow) is seen as elliptic structure situated medial and superficial to joint capsule and along lateral margin of iliopectineal eminence.

 


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  		Fig. 2A —Sonography-guided iliopsoas bursal injection in 27-year-old woman. Axial sonogram of iliopsoas tendon (t) with 22-gauge spinal needle (arrow) in position for sonography-guided injection. Lateral approach is used with transducer operating in sector format. Bony eminence of acetabulum (a) provides target for needle placement. Femoral head (fh) is labeled.

 


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  		Fig. 2B —Sonography-guided iliopsoas bursal injection in 27-year-old woman. Injection (long arrow) is performed while observing in real time. Fluid distention of bursa is illustrated with presence of microbubbles, producing echogenic foci along nondependent surface of bursa (short arrow, arrowhead).

 

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