MSK ultrasound of distal iliopsoas tendon attachment
Scanning the distal attachment, the insertion at the lesser trochanter, of the iliopsoas tendon by using the FABER maneuver achieved a complete longitudinal view. This technique is relatively simple and can help sonographers to diagnose and evaluate the (connective tissue repair of) the tendon.
To achieve the longitudinal view of the iliopsoas tendon the FABER maneuver [see header image above,or youtube video below] is used. This position involves hip flexion and abduction, and the patient is asked to externally rotate the hip joint as far as possible. The transducer is initially placed over the femoral head in a slightly oblique (from true longitudinal) fashion, approximating the course of the iliopsoas tendon as it courses over the hip joint. The iliopsoas tendon, which rests on top of the capsule, is then located longitudinally. In this position, it is easy to follow the tendon distally to its insertion on the lesser trochanter (LT: see image below). [Click on the link below to study this great full text article].
The distal iliopsoas is a musculotendinous complex formed by the main tendon from the psoas muscle and the fibers of the medial portion of the iliacus muscle with 2 components: an accessory tendon, which extends only from the iliacus muscle; and a muscle component in the most lateral part of the complex, which extends from the iliacus muscle and inserts onto the anterior side of the lesser trochanter and the subtrochanteric region.
Video: FABER test
> From: Balius et al., J Ultrasound Med 33 (2016) 2021-2030. All rights reserved to American Institute of Ultrasound in Medicine. Click here for the Pubmed summary.