Acute hip pseudoparalysis with calcific tendinitis at the insertion of the psoas muscle. Case report and first description of an atypical location

Calcific tendinitis is a common and widespread disease. It is most common in the rotator cuff especially in the supraspinatus tendon. In some cases it may also involve other locations such as the hips, particularly at the trochanter minor. In particular calcific tendinitis of the iliopsoas muscle te...

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Bibliographic Details
Published in:Zeitschrift für Rheumatologie 2013-03, Vol.72 (2), p.178-183
Main Authors: Zajonz, D, Moche, M, Tiepold, S, von Salis-Soglio, G, Pretzsch, M
Format: Article
Language:ger
Subjects:
Adult
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Calcinosis - diagnosis
Calcinosis - therapy
Combined Modality Therapy
Crutches
Diagnosis, Differential
Female
Hip - pathology
Humans
Ibuprofen - therapeutic use
Lithotripsy
Magnetic Resonance Imaging
Mobility Limitation
Multimodal Imaging
Pain Measurement
Paralysis - diagnosis
Paralysis - therapy
Positron-Emission Tomography
Psoas Muscles - pathology
Quality of Life
Rheumatic Diseases - diagnosis
Rheumatic Diseases - therapy
Tendinopathy - diagnosis
Tendinopathy - therapy
Tomography, X-Ray Computed
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Summary:Calcific tendinitis is a common and widespread disease. It is most common in the rotator cuff especially in the supraspinatus tendon. In some cases it may also involve other locations such as the hips, particularly at the trochanter minor. In particular calcific tendinitis of the iliopsoas muscle tendon has not yet been described. Because of uncharacteristic symptoms and ambiguous diagnostic imaging the differentiation between traumatic, infectious and neoplastic genesis is often difficult. Because of artefacts the typical calcareous spots near the insertions are often underdiagnosed in conventional diagnostic x-ray images. In this case report the differentiation from an infection of the hip was only possible with positron emission tomography computed tomography (PET-CT) imaging and negative microbiological testing of an aspirate. There are various therapy options, such as systemic and local medication, extracorporeal shock wave therapy up to surgery. However, calcific tendinitis is a self-limiting tendinopathy that can be treated with conservative therapy to complete remission in most cases.
ISSN:1435-1250
DOI:10.1007/s00393-012-1046-0