The prevalence of bifid iliopsoas tendon on MRI in children

Abstract

ObjectiveThe variation in the anatomy of the iliopsoas tendon is important information for orthopaedic surgeons operating around the hip. The aim of this study was to identify the prevalence of bifid iliopsoas tendons in children on magnetic resonance imaging (MRI).MethodsMRI hip and pelvis images of 50 sequential children aged 7–15 years were retrieved from our radiology database at the Evelina London Children’s Hospital from 2007 to 2013. Included were 37 children with imaging of both hips and 13 children with imaging of one hip only. Therefore, our study was based on a total of 87 hips.ResultsAt least 1 bifid tendon was noted in 13 children (26 %). Five children from a total of 37 (14 %) with both hips adequately imaged had bilateral bifid tendons. Among all 87 adequately imaged hips, 18 (21 %) were found to have two discrete distal iliopsoas tendons.ConclusionsBifid iliopsoas tendon is noted anecdotally by surgeons but was only reported in scattered case reports and a few anatomical studies until very recently. Our finding is that a bifid iliopsoas tendon with two distinct tendinous components at the level of the hip joint is quite common. This has clinical significance, particularly in children’s orthopaedic surgery when an adequate iliopsoas release is important.

Internal Snapping Hip Syndrome: Incidence of Multiple-Tendon Existence and Outcome After Endoscopic Transcapsular Release

“…Crompton et al 12 studied the prevalence of bifid iliopsoas tendons on MR imaging in 87 hips in children. A bifid tendon was noted in 13 children.…”

Endoscopic release of internal snapping hip: a review of literature

“…In an anatomical cadaveric study of 53 specimens by Philippon et al, two tendons were identified in 64.2% of cases, three tendons in 7.5% of cases, while a single tendon was found only in 28.3% of cases 24 . Crompton et al found a prevalence of a bifid iliopsoas tendon of 26% on MR imaging in 87 hips in children 25 . More recently, an incidence of multiple iliopsoas tendons of 18% during endoscopic transcapsular release have been reported 26 .…”

Arthroscopic release of iliopsoas tendon in patients with femoro-acetabular impingement: clinical results at mid-term follow-up

“…A few things are important to keep in mind while performing iliopsoas release. Re-cent studies showed that a multiple iliopsoas tendon may exists in a large number of patients 6,29 . Philippon et al 9 in a cadaveric study found that the iliopsoas tendon was composed by two tendons in 64.2% of cadavers, by three tendons in 7.5% of cases and a single tendon in only in 28.3% of cases.…”