Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, New York, USA.
Orthop J Sports Med. 2013 Aug 21;1(3):2325967113500638. doi: 10.1177/2325967113500638. eCollection 2013 Aug.
Coxa saltans refers to a constellation of diagnoses that cause snapping of the hip and is a major cause of anterior hip pain in dancers. When the internal type is accompanied by weakness or pain, it is referred to as iliopsoas syndrome. Iliopsoas syndrome is the result of repetitive active hip flexion in abduction and can be confused with other hip pathology, most commonly of labral etiology.
To report the incidence, clinical findings, treatment protocol, and results of treatment for iliopsoas syndrome in a population of dancers.
Retrospective case series; Level of evidence, 4.
A retrospective database review of 653 consecutive patients evaluated for musculoskeletal complaints over a 3-year period was completed. The diagnosis of iliopsoas syndrome was made based on anterior hip or groin pain, weakness with resisted hip flexion in abduction, or symptomatic clicking or snapping with a positive iliopsoas test. Patients identified with iliopsoas syndrome were further stratified according to age at time of onset, insidious versus acute onset, duration of symptoms, side of injury, presence of rest pain, pain with activities of daily living, and associated lower back pain. All patients diagnosed with iliopsoas syndrome underwent physical therapy, including hip flexor stretching and strengthening, pelvic mobilization, and modification of dance technique or exposure as required.
A total of 49 dancers were diagnosed and treated for iliopsoas syndrome. Within this injured population of 653 patients, the incidence in female dancers was 9.2%, significantly higher than that in male dancers (3.2%). The mean age at the time of injury was 24.6 years. The incidence of iliopsoas syndrome in dancers younger than 18 years was 12.8%, compared with 7% in dancers older than 18 years. Student dancers had the highest incidence (14%), followed by amateur dancers (7.5%), while professional dancers had the lowest incidence (4.6%). All patients responded to conservative treatment, and no patients required corticosteroid injections or surgical intervention.
This is the largest series reported to date of iliopsoas syndrome in the dance population, treated noninvasively. This study supports that conservative treatment with nonsteroidal anti-inflammatory medication, activity modification, and a physical therapy regimen specific to the iliopsoas should be the primary treatment for patients with iliopsoas syndrome.
This study supports current literature and conservative treatment of iliopsoas syndrome diagnosis. Furthermore, this study gives specific information regarding incidence of iliopsoas syndrome in dance populations and provides a test for diagnosis and an algorithm for treatment.
弹响髋是一组导致髋关节弹响的诊断，是舞蹈演员髋关节前侧疼痛的主要原因。当内侧型伴有无力或疼痛时，称为髂腰肌综合征。髂腰肌综合征是髋关节外展和主动屈曲的重复引起的，可能与其他髋关节病变混淆，最常见的是盂唇病变。
报告舞者人群中髂腰肌综合征的发病率、临床发现、治疗方案和治疗结果。
回顾性病例系列；证据水平，4 级。
对 3 年内接受肌肉骨骼检查的 653 例连续患者进行回顾性数据库回顾。髂腰肌综合征的诊断基于髋关节或腹股沟前侧疼痛、髋关节外展时抗阻力髋关节屈曲无力或阳性髂腰肌试验时出现症状性弹响或弹拨。根据发病时的年龄、隐匿性与急性发作、症状持续时间、损伤侧、休息时疼痛、日常活动时疼痛以及是否伴有下腰痛，对诊断为髂腰肌综合征的患者进行进一步分层。所有诊断为髂腰肌综合征的患者均接受物理治疗，包括髋关节屈肌伸展和强化、骨盆松动术以及根据需要调整舞蹈技术或暴露。
共有 49 名舞者被诊断和治疗髂腰肌综合征。在这 653 名受伤患者中，女性舞者的发病率为 9.2%，明显高于男性舞者（3.2%）。受伤时的平均年龄为 24.6 岁。18 岁以下舞者的髂腰肌综合征发病率为 12.8%，18 岁以上舞者的发病率为 7%。学生舞者发病率最高（14%），其次是业余舞者（7.5%），而专业舞者发病率最低（4.6%）。所有患者均对保守治疗有反应，无患者需要皮质类固醇注射或手术干预。
这是迄今为止报道的最大的舞蹈人群中髂腰肌综合征病例系列，采用非侵入性治疗。本研究支持非甾体抗炎药、活动调整和针对髂腰肌的物理治疗方案的保守治疗应作为髂腰肌综合征患者的主要治疗方法。
本研究支持目前关于髂腰肌综合征的文献和保守治疗。此外，本研究提供了关于舞蹈人群中髂腰肌综合征发病率的具体信息，并提供了诊断测试和治疗算法。
