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Iliopsoas hematoma presenting with sudden knee extensor weakness: A case report.
Jae Hoon Kim1, Seung Don Yoo2, Dong Hwan Kim2
1Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong.
Medicine
|December 17, 2020
Summary
A rare spontaneous iliopsoas muscle hematoma caused femoral neuropathy in a patient. Prompt diagnosis via imaging and electromyography, followed by aspiration and steroid therapy, led to improved motor function and reduced pain.
Area of Science:
- Neurology
- Radiology
- Musculoskeletal Medicine
Background:
- Iliopsoas muscle hematoma is a rare condition that can lead to femoral nerve compression.
- Femoral neuropathy presents with hip and thigh pain, and quadriceps weakness.
Observation:
- A 71-year-old woman with a history of hip replacement and aspirin use presented with acute hip pain and knee extensor weakness.
- Imaging revealed an iliopsoas hematoma compressing the femoral nerve.
Findings:
- Diagnosis was confirmed by computed tomography (CT) and magnetic resonance imaging (MRI), showing iliopsoas hematoma and femoral nerve displacement.
- Electromyography (EMG) indicated moderate left femoral neuropathy.
Implications:
- Ultrasound-guided aspiration and steroid pulse therapy improved motor function and pain.
- This case highlights the importance of imaging and EMG in diagnosing and managing iliopsoas hematoma causing femoral neuropathy.
