Anatomy-based MRI assessment of the iliopsoas muscle complex after pertrochanteric femoral fracture
Publication Details
Kaniewska, M.,
Schenkel, M.,
Eid, K.,
Buhler, T.,
Kubik-Huch, R.,
&
Anderson-Sembach, S.
(2019).
Anatomy-based MRI assessment of the iliopsoas muscle complex after pertrochanteric femoral fracture.
Skeletal Radiology: journal of radiology, pathology and orthopedics, 48 (3), 421-428.
Abstract
Objective: To evaluate the quality of the iliopsoas muscle complex after pertrochanteric femoral fracture, using MRI; to propose an anatomy-based evaluation of the iliopsoas muscle complex; and to determine the inter-reader reliability of two classifications of fatty muscle degeneration.
Materials and methods: We included adult patients with a displaced lesser trochanter following pertrochanteric femoral fracture. Muscle quality was evaluated using the Goutallier and Slabaugh classifications at three levels (L4/L5, L5/S1, and the anterior inferior iliac spine). Two radiologists independently reviewed the MRIs, and force measurement was performed on both hips. Linear mixed-effects models were used to determine the effect of fracture on muscle quality and strength, and Cohen’s kappa statistic was used to assess inter-reader agreement.
Results: In the 18 patients included, the iliopsoas muscle complex showed higher grades of fatty muscle degeneration on the fractured side than on the non-fractured side. The mean difference between muscle strength on the fractured vs the non-fractured side was −12 N (p > 0.05). Inter-reader agreement for the Goutallier and Slabaugh classifications was good and very good respectively (weighted K = 0.78 and 0.85 respectively).
Conclusion: Fatty muscle degeneration of the iliopsoas muscle complex after pertrochanteric femoral fracture was evident using both classification systems; however, fatty muscle degeneration resulted in only a minimal reduction of muscle strength. To provide a thorough assessment of iliopsoas muscle complex quality, we suggest evaluating it at different anatomical levels. Regarding inter-reader agreement, the Slabaugh classification was superior to the Goutallier classification.
Keywords
hip, hip joint, muscle strength, femoral fractures, skeletal muscle
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