The iliopsoas is the most powerful hip flexor and primary postural hip muscle. Its conjoined tendon snaps over the iliopectineal eminence in internal coxa saltans.
| Origin | Iliac fossa (iliacus) and T12-L5 vertebral bodies and discs (psoas major) |
|---|---|
| Insertion | Lesser trochanter via the conjoined tendon |
| Nerve Supply | Femoral nerve (L2, L3, L4) for iliacus; direct branches from L1-L3 for psoas |
| Blood Supply | Iliolumbar artery; Medial circumflex femoral artery at the lesser trochanter |
| Actions | Flexes the hip — primary flexor; Flexes lumbar spine when acting from the femur; Externally rotates the femur; Maintains lumbar lordosis in standing |
|---|
Iliopsoas tendinopathy produces anterior groin pain on resisted flexion. Internal snapping hip produces an audible anterior groin click. Iliopsoas release at the lesser trochanter addresses refractory cases. The Thomas test measures hip flexion contracture.
Iliacus palpated in the iliac fossa; psoas tendon medial to ASIS with hip in flexion during deep resisted flexion.
Iliopsoas tendon impingement on a prominent acetabular cup producing anterior groin pain, managed by cup revision or tendon release.
