Ischiofemoral impingement

The Richard Villar Practice, Spire Cambridge Lea Hospital, 30 New Road, Impington, Cambridge CB24 9EL, UK.
The Bone & Joint Journal (Impact Factor: 3.31). 10/2011; 93(10):1300-2. DOI: 10.1302/0301-620X.93B10.26714
Source: PubMed


Femoroacetabular impingement is a well-documented cause of hip pain. There is, however, increasing evidence for the presence of a previously unrecognised impingement-type condition around the hip - ischiofemoral impingement. This is caused by abnormal contact between the lesser trochanter of the femur and the ischium, and presents as atypical groin and/or posterior buttock pain. The symptoms are gradual in onset and may be similar to those of iliopsoas tendonitis, hamstring injury or bursitis. The presence of ischiofemoral impingement may be indicated by pain caused by a combination of hip extension, adduction and external rotation. Magnetic resonance imaging demonstrates inflammation and oedema in the ischiofemoral space and quadratus femoris, and is distinct from an acute tear. To date this has only appeared in the specialist orthopaedic literature as a problem that has developed after total hip replacement, not in the unreplaced joint.

93 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: The lower-extremity anatomy is complex and normal function is dependent on intact osteochondral, musculotendinous, and ligamentous structures. Injury may result in pain and functional limitation. Specific clinical tests are used to help isolate and define the pathoanatomy; however, their terminology may be confusing to the radiologist and the diagnostic value of these tests may not be well understood. This article presents an algorithmic approach to evaluation of the hip, knee, and ankle to improve the radiologist's understanding of lower-extremity physical examination. Knowledge of test terminology, clinical utility, and diagnostic accuracy will improve clinical and radiologic correlation. The article reviews the common clinical tests used to evaluate the lower extremity and provides an algorithm to establish a clinical examination road map and rapidly review the clinical utility and study hierarchy of a particular test. The sensitivity and specificity of the clinical tests and magnetic resonance (MR) imaging are reviewed because these parameters vary, and an understanding of the diagnostic utility of both the clinical and imaging tests is important in accurately formulating a definitive diagnosis. The structured algorithmic approach to lower-extremity examination described here, knowledge of test jargon, and familiarity with the diagnostic accuracy of the clinical and MR imaging examinations may help the radiologist focus image search patterns and provide detailed and clinically relevant reports. Online supplemental material is available for this article. ©RSNA, 2014.
    Radiographics 03/2014; 34(2):e41-55. DOI:10.1148/rg.342125066 · 2.60 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Ischiofemoral impingement (IFI) is the entrapment of the quadratus femoris muscle (QFM) between the trochanter minor of the femur and the ischium-hamstring tendon. Patients with IFI generally present with hip pain, which may radiate toward the knee. Although there is no specific diagnostic clinical test for this disorder, the presence of QFM edema/fatty replacement and narrowing of the ischiofemoral space and the quadratus femoris space on magnetic resonance imaging (MRI) are suggestive of IFI. The optimal treatment strategy of this syndrome remains obscure. Patients may benefit from a conservative treatment regimen that includes rest, activity restriction, nonsteroidal anti-inflammatory drugs, and rehabilitation procedures, just as with other impingement syndromes. Herein we report an 11-year-old girl with IFI who was successfully treated conservatively. To our knowledge, our case is the youngest patient reported in the English literature. MRI remains an important tool in the diagnosis of IFI, and radiologists should be aware of the specific features of this entity.
    Diagnostic and interventional radiology (Ankara, Turkey) 06/2012; 18(6). DOI:10.4261/1305-3825.DIR.5728-12.1 · 1.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Hamstring injuries are common in sports. Although management and outcomes are sport specific, clinical evaluation alone is a poor guide for treatment planning and prognostication. Cross-sectional imaging has added value in these cases. Conclusion: Specifically, the location (tendon attachment, classic or intramuscular myotendinous junction, or extramuscular portion of the tendon), specific muscles involved, and anatomic extent are factors that can influence the immediate treatment, expected convalescent period, and risk of recurrence in these athletes.
    American Journal of Roentgenology 09/2012; 199(3):525-33. DOI:10.2214/AJR.12.8784 · 2.73 Impact Factor
Show more