Clinical Characteristics and Functional Outcomes After Rehabilitation in Femoral Neuropathy Secondary to Iliopsoas Hematomas: A Case Series Report

Abstract

Iliopsoas haematoma is an uncommon but potentially severe complication, most frequently associated with anticoagulation therapy. When voluminous, it may compress the femoral nerve, leading to disabling motor and sensory deficits. We report three elderly patients, all anticoagulated, who developed femoral neuropathy secondary to iliopsoas haematomas. Clinical presentations ranged from acute abdominal and groin pain to sudden gait impairment and severe motor weakness. Imaging confirmed iliacus and/or psoas haematomas, and electromyography demonstrated significant neurogenic compromise. All patients were managed conservatively, with anticoagulation suspension or reversal, and early rehabilitation. Despite partial recovery in one patient, persistent deficits compromised autonomy, requiring long-term care in the other two. These cases highlight the importance of early recognition, prompt imaging, and multidisciplinary rehabilitation. Given the significant functional consequences but scarce discussion of this diagnosis in the literature, reporting such cases is essential to raise awareness among clinicians.