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Bilateral presence of psoas minor muscle and its morphometric analysis: a case report

Journal Name:

  • Indian Journal of Basic & Applied Medical Research

Publication Year:

  • 2014

Key Words:

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Abstract (2. Language): 
The psoas minor, present in only two out of every three individuals, is a slender muscle lying on the surface of psoas major. Psoas minor at its origin lies just in front of the psoas major muscle has small belly and long tendon like plantaris and palmaris longus muscle. The Psoas Minor Muscle is considered inconstant and it’s often absent. This muscle consists of a short proximal fixation tendon originated from the sides of the twelfth thoracic vertebra, first lumbar vertebra and corresponding intervertebral disc, continuous with a short spindle-shaped morphology muscular venter, ending with a long distal fixation tendon inserted in the pectineal line of the pubis and iliopectineal eminence. Psoas minor receives its nerve supply from the ventral rami of L1 spinal nerves, which after piercing through the psoas major muscle enter into the muscular belly. Psoas minor also is subject to racial and ethnic variation. During a routine anatomical dissection for medical students, we found bilateral presence of psoas minor muscle.
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REFERENCES

References: 

1. Gray H. Anatomia. 29th ed. Rio di Janeiro: Guanabara Kougan; 1977.
2. Moore K, Dally K. Anatomia orienteda para a clinica. 5th ed. Rio di Janeiro: Guanabara Kougan; 2007.
3. Tellez V, Acuna L. Consideraciones Anatomicas de los Musculos Inconstantes. Med Unab; 1998.
4. Danillo Ribeiro Guerra, Francisco Prado Reis, Afrânio de Andrade Bastos,, Ciro José Brito, Roberto
Jerônimo dos Santos Silva ,José Aderval Aragão: Anatomical Study on the Psoas Minor Muscle in Human
Fetuses. Int. J. Morphol:2012;30(1):136-9.
5. Kraychete, D. C.; Rocha, A. P. & Castro, P. A. Psoas muscle abscess after epidural analgesia: case report.
Rev. Bras. Anestesiol., 2007;57:195-8.
221
Discussion:
According to Kraychete, the psoas minor muscle was
present in only 30% of the cases. Regarding sex, there
was no significant difference [5]. The tendon of this
muscle was very
long [6]. The tendon represented 57% of the total
length of the muscle[4].
In all the foetuses (danillo et al) the fibres of the psoas
minor muscle originated in the bodies of the 12th
thoracic vertebra and the underlying intervertebral disc,
as also found by Lee et al. and Torres et al.(1995).The
fibers of the psoas minor muscle originated as a
ramification of the fibers of the psoas major in
some cases by Macalister [7].
The duplication of psoas minor has also been seen in
the past, where the first belly overlapped the other from
before backwards. Infrequently, the ramifications of
muscular fibres of psoas major yielding psoas minor
have been mentioned as source of unusual origin. Not
only can the frequency of its presence vary, but also its
morphology. It is not rare to find the psoas minor
muscle reduced to only one or two tendons[4].In a
description by Gardner et al, they reported that this
muscle was inserted by means of a thin tendon, into the
iliopubic eminence and into the arched line, and that it
had an additional inconstant insertion into the iliac
fascia (as found in this case)and pectineal ligament[8].
Usually the muscle inserts at the pelvis but sometimes
the insertion tendon can descend further down up to the
femur making it prone to overstrain. In the long run, it
becomes stiff and less flexible. The psoas minor
syndrome is attributed to unusual high tone in psoas
minor muscle and tendon where, the patient complaints
of pain in the lower quadrant of the abdomen. In
addition, the pain was aggravated by palpation of the taut
tendon in lean individuals presenting with acute
abdomen, often mistaken for appendicitis. In this
syndrome, there is the limited extension, which impairs
ambulation. Tenotomy is the only treatment of choice,
which relieves the symptoms[9]. The comprehension of
these muscular variations allows insight into the pattern
of localization and spread of infection and malignancy in
the retroperitoneal region of the body[10].
Conclusion:
Psoas minor muscle is regressive muscle. Although the
knowledge of normal anatomy and variation of psoas
minor is essential because someone that has the muscle
and strains it, however, can expect a 50 percent reduction
in range of hip motion. Muscle inserts at the pelvis but
sometimes the insertion tendon can descend further down
up to the femur making it prone to overstrain may lead
to psoas minor syndrome. Psoas minor also is subject to
racial and ethnic variation. So anatomist and surgeons
should aware of its anatomy.
Indian Journal of Basic and Applied Medical Research; December 2014: Vol.-4, Issue- 1, P. 218-222
222
www.ijbamr.com P ISSN: 2250-284X , E ISSN : 2250-2858
6. Macalister, A. Additional observations on muscular anomalies in human anatomy (third series), with a
catalogue of the principal muscular variations hitherto published. Trans. Roy. Irish. Acad.1875;25:1-130.
7. Gardener, E.; Gray, D. J. & O'rahilly, R. O abdome. In: Gardener, E.; Gray, D. J. & O'Rahilly, R.
Anatomia. Parede abdominal posterior. 4a ed. Rio de Janeiro, GuanabaraKoogan, 1988: pp.356.
8. Travell J, Simons D. Myofascial Pain and Dysfunction: The Trigger Point Manual; Vol. 2., The Lower
Extremities. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 1998.
9. Dyke JAV, Holley HC, Anderson SD. Review of Iliopsoas anatomy and pathology. Radiographics. 1987
Jan 1;7(1):53–84

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