A New Method for Ultrasound Evaluation of the Iliopsoas Tendon insertion
Sonographic evaluation of the iliopsoas insertion is difficult using the traditional sagittal approach from the anterior aspect of the hip. The difficulties arise due to the depth of the tendon and the steep course to the lesser trochanter resulting in anisotropy. Refraction artifact from the overlying sartorius, rectus femoris and vastus medialis muscle edges, combined with the femoral neurovascular bundle further degrade the image.
I describe a new sonographic technique which overcomes these difficulties and produces images of excellent definition. Abduction and external rotation of the hip, combined with an approach angled steeply through the pectineus, adductor longus and adductor brevis muscle bellies provides an excellent acoustic window and imaging perpendicular to the tendon insertion free of anisotropy.