Taylor G R, Clarke N M
Southampton University Hospitals NHS Trust, England, UK.
J Bone Joint Surg Br. 1995 Nov;77(6):881-3.
We report 22 patients (19 women and three men) of mean age 20.8 years who had painful snapping sensations in the groin. Most were able to reproduce the click by extending the affected hip from a flexed, abducted and externally rotated position and most were tender in the adductor triangle. Plain radiographs and an arthrogram were normal. A clinical diagnosis of subluxation of the iliopsoas tendon was made. Conservative management failed in 14 patients, two of whom had bilateral pain. All 14 had surgical release of the iliopsoas tendon through a medial approach. At follow-up (mean 17 months) the click had resolved in ten hips, was occasional but painless in five and unchanged in one. The syndrome of a painful 'snapping' psoas may result in disproportionately disabling symptoms. It may be diagnosed on clinical grounds and effectively treated, when severe, by release of the iliopsoas tendon.
我们报告了22例平均年龄为20.8岁的患者（19名女性和3名男性），他们腹股沟处有疼痛的弹响感。大多数患者能够通过将患侧髋关节从屈曲、外展和外旋位伸展来重现弹响，且大多数患者在内收肌三角区有压痛。X线平片和关节造影均正常。临床诊断为髂腰肌肌腱半脱位。14例患者保守治疗失败，其中2例为双侧疼痛。所有14例患者均通过内侧入路对髂腰肌肌腱进行了手术松解。随访（平均17个月）时，10个髋关节的弹响消失，5个髋关节偶尔有弹响但无痛，1个髋关节弹响无变化。疼痛性“弹响”腰大肌综合征可能导致不成比例的致残症状。可根据临床情况进行诊断，严重时通过松解髂腰肌肌腱可有效治疗。
