The Limited Reliability of Physical Examination and Imaging for Diagnosis of Iliopsoas Tendinitis.

To determine if any association exists between physical examination, imaging findings [ultrasound (US) and magnetic resonance imaging (MRI)], and iliopsoas tendinitis (IPT) to characterize the reliability of these diagnostic modalities. Patients who had undergone US-guided iliopsoas tendon sheath injection (of lidocaine and a corticosteroid agent) as well as MRI performed within 1 year of injection from 2014 to 2019 were retrospectively reviewed. Demographic data, response to physical exam maneuvers, and response to injection were queried from patient records. US and MRI were reviewed by 2 independent musculoskeletal-trained radiologists. Response to injection was considered positive if the patient improved by >2 points on a 0- to 10-point VAS score. Chi-squared and Fisher exact testing were used to assess for any associations. Sensitivities, specificities, positive predictive values, and negative predictive values were calculated. Sixty-three patients, age 52.3 ± 17.3 years (mean ± standard deviation), body mass index 27.4 ± 4.3 kg/m Neither physical examination nor US or MRI findings were associated with a positive response to peritendinous iliopsoas corticosteroid injections in patients with suspected IPT. III, retrospective comparative trial limited by lack of a reference standard for iliopsoas tendonitis diagnosis.

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