Screw penetration of the iliopsoas muscle causing late-onset pain after total hip arthroplasty: A case report

Figure 1 Anterolateral pelvis radiographs of the case. A: Immediately following the index total hip arthroplasty; B: At the time of initial visit to our institution.

Figure 2 Images showing potential iliopsoas impingement by the cup. A: Ultrasonography demonstrating a protruded acetabular rim (arrow) in approximation to the iliopsoas tendon (arrow head); B: Axial computed tomography scan showing a retroverted cup by 9°.

Figure 3 Advance images showing screw protrusion. A: Three-dimensional reconstruction of a computed tomography image showing the screw penetrating through the ilium; B: Magnetic resonance imaging showing the screw penetrating through the iliopsoas muscle (arrow).

Figure 4 Clinical photos from surgical intervention. A: Exposure of the screw using the pararectus approach; B: Close-up look of the protruding screw; C: Following flattening of the screw.

Figure 5 Immediate postoperative radiographs. A: Showing the flattened screw tip (arrow); B: Complete resection of the screw (as compare to Figure 3B).