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Published on: April 17, 2019
The prevalence of bifid iliopsoas tendon on MRI in children
Thomas Crompton1, Claire Lloyd, Michail Kokkinakis
1Department of Paediatric Orthopaedic Surgery, Evelina London Children's Hospital Guy's and St Thomas' NHS Foundation Trust, London, UK, crompton.tom@gmail.com.
Insights
Bifid iliopsoas tendons, where the tendon splits into two parts, are common in children. This anatomical variation is important for pediatric orthopedic surgeons performing hip surgery.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Anatomy
- Radiology
Background:
- Anatomical variations of the iliopsoas tendon are clinically relevant for hip surgery.
- Previous reports on bifid iliopsoas tendons were limited to case studies and anatomical research.
Purpose of the Study:
- To determine the prevalence of bifid iliopsoas tendons in children using magnetic resonance imaging (MRI).
Main Methods:
- Retrieved and reviewed MRI scans of the hip and pelvis from 50 children aged 7-15 years.
- Analyzed a total of 87 hips from the imaging data.
- Identified the presence and characteristics of bifid iliopsoas tendons.
Main Results:
- A bifid iliopsoas tendon was observed in 26% of the children studied (13 out of 50).
- Bilateral bifid tendons were present in 14% of children with both hips imaged.
- Overall, 21% of the 87 hips examined showed two distinct distal iliopsoas tendons.
Conclusions:
- Bifid iliopsoas tendons are more common than previously suggested by anecdotal reports.
- This anatomical finding has significant implications for pediatric orthopedic procedures, especially iliopsoas tendon release.
- Accurate identification of bifid iliopsoas tendons is crucial for successful surgical outcomes in children.
Objective:
The 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).
Methods:
MRI 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.
Results:
At 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.
Conclusions:
Bifid 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.
