Ischiofemoral Impingement: Assessment of Diagnosis through MRI and Physical Examination


Abstract views: 137 / PDF downloads: 195

Authors

DOI:

https://doi.org/10.58600/eurjther1982

Keywords:

Hip pain, Ischiofemoral impingement, Magnetic resonance imaging, Quadratus femoris muscle

Abstract

Objective: The objective of this study is to assess the precision of physical examination tests in individuals diagnosed with ischiofemoral impingement syndrome (IFI), analyze magnetic resonance imaging (MRI) findings and measurements, and explore the correlation between imaging methods and physical examination tests.

Methods: The MRIs of 27 hips of 20 patients who have presented with complaints of hip/groin pain in the study group and 40 hips of 20 patients in the control group were analyzed. Patients were evaluated for the severity of pain, clinical findings, and physical examination tests. Quadratus femoris muscle (QFM) edema was graded and quadratus femoris space (QFS), hamstring tendon area (HTA) and especially ischiofemoral space (IFS), were measured on MRI.

Results: Both the IFS (12.44±3.49) and QFS (6.38±2.09) were significantly reduced in the study groups compared to the control groups (IFS:23.06±4.5, p<0.001; QFS:15.36±4.45, p<0.001). Measurements of the IFS (cut-off:≤18.58) and the QFS (cut-off:≤10.27) demonstrated high specificity (87.5%) and sensitivity (100%) in identifying IFI. The long-step walking (LSW) test was positive in 59.3% of cases.

Conclusion: The results suggest that MRI is a valuable tool for providing detailed information on various aspects related to IFI. It allows for the assessment of the narrowing of the IFS and QFS, as well as the presence of edema. MRI, when combined with LSW test, can contribute to a comprehensive evaluation and diagnosis of IFI, enabling clinicians to gather important clinical and radiological data for accurate assessment.

Metrics

Metrics Loading ...

References

Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA (2009) Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol 193(1):186-90. https://doi.org/10.2214/AJR.08.2090

Johnson K (1977) Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty. Report of three cases. JBJS 59(2):268-9. https://doi.org/10.2106/00004623-197759020-00028

Tosun O, Algin O, Yalcin N, Cay N, Ocakoglu G, Karaoglanoglu M (2012) Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skeletal Radiol 41(5):575-87. https://doi.org/10.1007/s00256-011-1257-5

Hernando MF, Cerezal L, Pérez-Carro L, Canga A, González RP (2016) Evaluation and management of ischiofemoral impingement: a pathophysiologic, radiologic, and therapeutic approach to a complex diagnosis. Skeletal radiol. 45(6):771-87. https://doi.org/10.1007/s00256-016-2354-2

Patti JW, Ouellette H, Bredella MA, Torriani M (2008) Impingement of lesser trochanter on ischium as a potential cause for hip pain. Skeletal Radiol 37(10):939-41. https://doi.org/10.1007/s00256-008-0551-3

Kassarjian A. (2008) Signal abnormalities in the quadratus femoris muscle: tear or impingement? AJR Am J Roentgenol 190(6):W379; author reply W380-1. https://doi.org/10.2214/ajr.07.3540

Gómez-Hoyos J, Martin RL, Schröder R, Palmer IJ, Martin HD (2016) Accuracy of 2 clinical tests for ischiofemoral impingement in patients with posterior hip pain and endoscopically confirmed diagnosis. Arthroscopy. 32(7):1279-84. https://doi.org/10.1016/j.arthro.2016.01.024

Chamberlain R (2021) Hip Pain in Adults: Evaluation and Differential Diagnosis. Am Fam Physician 15;103(2):81-9.

Akça A, Şafak KY, İliş ED, Taşdemir Z, Baysal T (2016) Ischiofemoral impingement: assessment of MRI findings and their reliability. Acta Ortop Bras 24(6):318-21. https://doi.org/10.1590/1413-785220162406162686

Xing Q, Feng X, Wan L, Cao H, Bai X, Wang S (2023) MRI measurement assessment on ischiofemoral impingement syndrome. HIP Int 33(1):119-125. https://doi.org/10.1177/11207000211007750

Khodair SA, Ghieda UE, Elsayed AS (2014) Ischiofemoral impingement syndrome: spectrum of MRI findings in comparison to normal subjects. The Egyptian Journal of Radiology and Nuclear Medicine 45(3):819-24. https://doi.org/10.1016/j.ejrnm.2014.02.012

Bredella MA, Azevedo DC, Oliveira AL, Simeone FJ, Chang CY, Stubbs AJ, Torriani M (2015) Pelvic morphology in ischiofemoral impingement. Skeletal radiol 44(2):249-53. https://doi.org/10.1007/s00256-014-2041-0

Wang Y, Liang W, Chen Y, Li S, Ji H, Feng Z, Ma D, Zhong S, Ouyang J, Qian L (2023) Sex‐specific bone and muscular morphological features in ischiofemoral impingement: A three‐dimensional study. Clin Anat. 36(8):1095-1103. https://doi.org/10.1002/ca.24036

Taneja AK, Bredella MA, Torriani M (2013) Ischiofemoral impingement. Magn Reson Imaging Clin N Am. 21(1):65-73. https://doi.org/10.1016/j.mric.2012.08.005

Lerch TD, Zwingelstein S, Schmaranzer F, Boschung A, Hanke MS, Todorski IA, Steppacher SD, Gerber N, Zeng G, Siebenrock KA (2021) Posterior Extra-articular Ischiofemoral Impingement Can Be Caused by the Lesser and Greater Trochanter in Patients With Increased Femoral Version: Dynamic 3D CT–Based Hip Impingement Simulation of a Modified FABER Test. Orthopaedic Journal of Sports Medicine 9(5). https://doi.org/10.1177/2325967121990629

Singer AD, Subhawong TK, Jose J, Tresley J, Clifford PD (2015) Ischiofemoral impingement syndrome: a meta-analysis. Skeletal radiol 44(6):831-7. https://doi.org/10.1007/s00256-015-2111-y

Stenhouse G, Kaiser S, Kelley SP, Stimec J (2016) Ischiofemoral impingement in children: imaging with clinical correlation. Am J Roentgenol 206(2):426-30. https://doi.org/10.2214/AJR.15.14909

Özdemir ZM, Yildirim T, Karaca L, Kahraman AS, Aydingöz Ü (2021) A Novel Physical Examination Test for Ischiofemoral Impingement: Validation With Magnetic Resonance Imaging Correlation. J Comput Assist Tomogr 45(5):722-7. https://doi.org/10.1097/RCT.0000000000001227

Kivlan BR, Martin RL, Martin HD (2017) Ischiofemoral impingement: defining the lesser trochanter–ischial space. Knee Surg Sports Traumatol Arthrosc 25(1):72-6. https://doi.org/10.1007/s00167-016-4036-y

Park S, Lee HY, Cuong PM, Won Y-Y, Ji H-M, Yoon S-H, Kwack K-S (2016) Supine versus standing radiographs for detecting ischiofemoral impingement: a propensity score-matched analysis. AJR Am J Roentgenol 206(6):1253-63. https://doi.org/10.2214/AJR.15.15186

Hatem MA, Palmer IJ, Martin HD (2015) Diagnosis and 2-year outcomes of endoscopic treatment for ischiofemoral impingement. Arthroscopy 31(2):239-46. https://doi.org/10.1016/j.arthro.2014.07.031

Vicentini JR, Martinez-Salazar EL, Simeone FJ, Bredella MA, Palmer WE, Torriani M (2021) Kinematic MRI of ischiofemoral impingement. Skeletal Radiol 50(1):97-106. https://doi.org/10.1007/s00256-020-03519-4

Finnoff JT, Bond JR, Collins MS, Sellon JL, Hollman JH, Wempe MK, Smith J (2015) Variability of the ischiofemoral space relative to femur position: an ultrasound study. PM&R 7(9):930-7. https://doi.org/10.1016/j.pmrj.2015.03.010

Downloads

Published

2024-02-25

How to Cite

Ozcan, A. G., Fazliogullari, Z., Karabulut, A. K., Albayrak Gezer, I., Ozer, H., Sevindik, S., & Unver Dogan, N. (2024). Ischiofemoral Impingement: Assessment of Diagnosis through MRI and Physical Examination. European Journal of Therapeutics. https://doi.org/10.58600/eurjther1982

Issue

Section

Original Articles

Categories