Neurovascular Compression Caused by Popliteus Muscle Enlargement Without Discrete Trauma

Cho, Kyoung Jin; Kang, Sangkuk; Ko, Sanghyung; Baek, Junghyun; Kim, Yeongkyun; Park, Noh Kyoung

doi:10.5535/arm.2016.40.3.545

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…2,4,11,12,[14][15][16][17][18] The femoral nerve (FN) descends in a groove between psoas and iliacus muscles, deep to the iliac fascia, passing under the inguinal ligament and it enters the thigh where it gives its terminal branches. 5,19,20 Compression to the FN has mostly been described as being due to bleeding disorders, when an iliac haematoma compresses it at three possible levels: against the inguinal ligament; at its lumbar roots; or in the space between the psoas and iliacus muscles where the overlying fascia is thicker. [20][21][22][23][24] The principal symptoms are thigh weakness along with the anterior thigh and medial leg numbness.…”

Section: Introductionmentioning

confidence: 99%

“…When severe, the patient may be unable to stand without support. [19][20][21][22][23][24][25] Several reports have described variant muscular slips or sheets forming longitudinal fascicles or wide bands associated with psoas and iliacus, but most of them are not related to the FN. 1,4 The iliopsoas tendon or muscle may be split by the FN, but we have found only two reports that describe the FN itself being split by iliopsoas muscle slips.…”

Section: Introductionmentioning

confidence: 99%

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Macroscopic observations of muscular bundles of accessory iliopsoas muscle as the cause of femoral nerve compression

Unat

Şirintürk

Çağımnı

et al. 2019

Journal of Orthopaedics

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Compression of the femoral nerve (FN) to the iliac fossa has been reported as a consequence of several pathologies as well as due to the aberrant muscles. The purpose of this research was to investigate the patterns of the accessory muscles of iliopsoas muscles and the relationship of the FN in fifty semi pelvis. Accessory muscular slips from iliacus and psoas, piercing or covering the FN, were found in 19 specimens (7.9%). Based on the macroscopic structure, the muscle was categorized into two types. Pattern 1 as the more frequent variation, was sheet muscular type covering the FN (17 specimens, 89.5%). Pattern 2, the less frequent variation was found on a muscular slip covering the FN (2 specimens, 10.5%). Iliac and psoas muscles and their variants on both types were defined. Appraising the relation between the muscle and the nerves, each disposition of the patterns may be a potential risk for nerve entrapment. The knowledge about the possible variations of the iliopsoas muscle complex and the FN may also give surgeons confidence during pelvic surgery. Recognition of these variations in normal anatomy may be useful to the clinicians when treating patients with refractory leg pain.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Macroscopic observations of muscular bundles of accessory iliopsoas muscle as the cause of femoral nerve compression

Unat

Şirintürk

Çağımnı

et al. 2019

Journal of Orthopaedics

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“…One study reported that PM syndrome was caused by an isolated PM due to compression of the neurovascular bundle. In this case, the patient felt calf pain and numbness in the posterolateral aspect of the calf and sole [ 17 ]. Because the PM and popliteal artery are adjacent to each other, the condition of this muscle affects the blood circulation of the popliteal artery.…”

Section: Discussionmentioning

confidence: 99%

“…Next, we surveyed the results of previous studies examining the shape of the PM and the surrounding structures to which it is connected [ 1 , 16 , 17 ]. The PM was shown to have a triangular shape [ 2 ] and is attached to surrounding ligaments and meniscus [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Nerve and Arterial Supply Pattern of the Popliteus Muscle and Clinical Implications

Jeon

Kim

Sohn

et al. 2022

BioMed Research International

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Introduction. The aim of this study was to investigate the nerve and artery supply and the tibial attachment of the popliteus muscle using anatomical methods. Methods. Forty-four nonembalmed and embalmed extremities were dissected for this study. To measure the attachment area of the popliteus, the most prominent points of the medial epicondyle of the femur and the medial malleolus of the tibia were identified before dissection. A line connecting these two prominent points was used as the reference line, with the most prominent point of the medial epicondyle of the femur as the starting point. This study also investigated the area where the popliteus attaches to the bone and the points where nerves and arteries enter the popliteus muscle when it is divided into three equal parts in the coronal plane. Results. The mean length of the reference line was 34.6 ± 2.1 cm . The origin of the popliteus was found to be at a distance of 16.6% to 35.2% on the tibial bone from the proximal region. The popliteus was innervated by only the tibial nerve in 90% of the cases and by the tibial and the sciatic nerves in the remaining 10% of the cases. The inferior medial genicular artery and the posterior tibial artery supplied blood to the popliteus in 90% and 65% of the cases, respectively. When the popliteus muscle was divided into three equal parts in the coronal plane, the nerve and the artery were found to enter the muscle belly in zones II and III and zones I and II in 92% and 98% of the specimens, respectively. Discussion. The anatomical investigation of the popliteus in this study will help identify patients with clinically relevant syndromes.

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“…The main etiological reason for PTN entrapments is space-occupying lesions. We found several cases in the literature: tibial arterial aneurysm [18] and pseudoaneurysm [16], intraneural ganglion cysts [19], Baker's cysts [20], tibial bone exostosis [21], and popliteal muscle enlargement [22]. In these cases, the space-occupying lesions either shifted the nerve to the fibrous sling of the soleus muscle or were the primary reason for entrapment, by compressing the nerve with mass effect.…”

Section: Anatomy Etiology and Pathophysiologymentioning

confidence: 99%

Diagnostic Approach to Lower Limb Entrapment Neuropathies: A Narrative Literature Review

Drăghici,

Văcăraș,

Bolchis

et al. 2023

Diagnostics

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Entrapment neuropathies of the lower limb are a misunderstood and underdiagnosed group of disorders, characterized by pain and dysesthesia, muscular weakness, and specific provoking movements on physical examination. The most frequent of these syndromes encountered in clinical practice are fibular nerve entrapment, proximal tibial neuropathy, sural nerve neuropathy, deep gluteal syndrome or sciatic nerve entrapment, and lateral femoral cutaneous nerve entrapment, also known as meralgia paresthetica. These are commonly mistaken for lumbar plexopathies, radiculopathies, and musculotendinous diseases, which appear even more frequently and have overlapping clinical presentations. A comprehensive anamnesis, physical examination, and electrodiagnostic studies should help clarify the diagnosis. If the diagnosis is still unclear or a secondary cause of entrapment is suspected, magnetic resonance neurography, MRI, or ultrasonography should be conducted to clarify the etiology, rule out other diseases, and confirm the diagnosis. The aim of this narrative review was to help clinicians gain familiarity with this disease, with an increase in diagnostic confidence, leading to early diagnosis of nerve damage and prevention of muscle atrophy. We reviewed the epidemiology, anatomy, pathophysiology, etiology, clinical presentation, and EDX technique and interpretation of the entrapment neuropathies of the lower limb, using articles published from 1970 to 2022 included in the Pubmed, MEDLINE, Cochrane Library, Google Scholar, EMBASE, Web of Science, and Scopus databases.

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Neurovascular Compression Caused by Popliteus Muscle Enlargement Without Discrete Trauma

Cited by 6 publications

References 9 publications

Macroscopic observations of muscular bundles of accessory iliopsoas muscle as the cause of femoral nerve compression

Macroscopic observations of muscular bundles of accessory iliopsoas muscle as the cause of femoral nerve compression

Nerve and Arterial Supply Pattern of the Popliteus Muscle and Clinical Implications

Diagnostic Approach to Lower Limb Entrapment Neuropathies: A Narrative Literature Review

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