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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Ischiofemoral Impingement Syndrome: Effect of Morphological Variations on the Diagnosis

Author(s): Ali Dablan*, Cemil Oktay and Can Çevikol

Volume 17, Issue 5, 2021

Published on: 18 November, 2020

Page: [595 - 601] Pages: 7

DOI: 10.2174/1573405616666201118124715

Abstract

Objective: The purpose of this study is to clarify which morphologic variations of the hip on MRI are associated with the development of ischiofemoral impingement.

Methods: Hip MRIs of patients who have been referred to our department between 2016-2017 were retrospectively reviewed and assessed for pathological signal changes in the quadratus femoris muscle and ipsilateral hip or buttock pain. After assessment, ischial angle, inclination angle, ischiofemoral space, quadratus femoris space, intertuberous distances and femur neck angle, femoral torsion angle and knee angle were measured and compared in 37 hips of 20 patients and 56 hips of 28 age-gender matched control subjects.

Results: There were statistically significant differences between the patient and control groups in all MRI parameters except for intertuberous distances (p<0.05). Quadratus femoris space (p<0.001) and ischiofemoral space (p<0.001) were significantly lower and femoral torsion angle (p=0.02), femur neck angle (p=0.001), ischial angle (p=0.01) and inclination angle (p=0.03) values were significantly higher in patients compared with the control group.

Conclusion: Decreased ischiofemoral space and quadratus femoris space, increased femoral torsion angle, femur neck angle, ischial angle and inclination angle are found to be associated with IFI on MRI. These pelvic anatomical variations may predispose to ischiofemoral impingement and should be kept in mind for patients with hip pain.

Keywords: Ischiofemoral impingement, hip pain, pelvic morphology, magnetic resonance imaging, quadratus femoris muscle, quadratus femoris space.

Graphical Abstract

[1]
Tosun O, Algin O, Yalcin N, Cay N, Ocakoglu G, Karaoglanoglu M. Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skeletal Radiol 2012; 41(5): 575-87.
[http://dx.doi.org/10.1007/s00256-011-1257-5] [PMID: 21874607]
[2]
Ohnishi Y, Suzuki H, Nakashima H, et al. Radiologic correlation between the ischiofemoral space and morphologic characteristics of the hip in hips with symptoms of dysplasia. AJR Am J Roentgenol 2018; 210(3): 608-14.
[http://dx.doi.org/10.2214/AJR.17.18465] [PMID: 29381377]
[3]
Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol 2009; 193(1): 186-90.
[http://dx.doi.org/10.2214/AJR.08.2090] [PMID: 19542413]
[4]
Gollwitzer H, Banke IJ, Schauwecker J, Gerdesmeyer L, Suren C. How to address ischiofemoral impingement? Treatment algorithm and review of the literature. J Hip Preserv Surg 2017; 4(4): 289-98.
[5]
Patti JW, Ouellette H, Bredella MA, Torriani M. Impingement of lesser trochanter on ischium as a potential cause for hip pain. Skeletal Radiol 2008; 37(10): 939-41.
[http://dx.doi.org/10.1007/s00256-008-0551-3] [PMID: 18682931]
[6]
Sutter R, Pfirrmann CW. Atypical hip impingement. AJR Am J Roentgenol 2013; 201(3): W437-42.
[http://dx.doi.org/10.2214/AJR.13.10692] [PMID: 23971474]
[7]
Taneja AK, Bredella MA, Torriani M. Ischiofemoral impingement. Magn Reson Imaging Clin N Am 2013; 21(1): 65-73.
[http://dx.doi.org/10.1016/j.mric.2012.08.005] [PMID: 23168183]
[8]
Gardner SS, Dong D, Peterson LE, Park KJ, Harris JD. Is there a relationship between femoral neck-shaft angle and ischiofemoral impingement in patients with hip pain? J Hip Preserv Surg 2020; 7(1): 43-8.
[9]
Sussman WI, Han E, Schuenke MD. Quantitative assessment of the ischiofemoral space and evidence of degenerative changes in the quadratus femoris muscle. Surg Radiol Anat 2013; 35(4): 273-81.
[http://dx.doi.org/10.1007/s00276-012-1029-5] [PMID: 23076730]
[10]
Salerno G, Daniels IR, Brown G, Heald RJ, Moran BJ. Magnetic resonance imaging pelvimetry in 186 patients with rectal cancer confirms an overlap in pelvic size between males and females. Colorectal Dis 2006; 8(9): 772-6.
[http://dx.doi.org/10.1111/j.1463-1318.2006.01090.x] [PMID: 17032323]
[11]
Siebenrock KA, Steppacher SD, Haefeli PC, Schwab JM, Tannast M. Valgus hip with high antetorsion causes pain through posterior extraarticular FAI. Clin Orthop Relat Res 2013; 471(12): 3774-80.
[http://dx.doi.org/10.1007/s11999-013-2895-9] [PMID: 23463288]
[12]
Unlu MC, Kesmezacar H, Kantarci F, Unlu B, Botanlioglu H. Intraoperative estimation of femoral anteversion in cementless total hip arthroplasty using the lesser trochanter. Arch Orthop Trauma Surg 2011; 131(9): 1317-23.
[http://dx.doi.org/10.1007/s00402-011-1282-9] [PMID: 21359870]
[13]
Bredella MA, Azevedo DC, Oliveira AL, et al. Pelvic morphology in ischiofemoral impingement. Skeletal Radiol 2015; 44(2): 249-53.
[PMID: 25371087]
[14]
Audenaert EA, Khanduja V, Claes P, Malviya A, Steenackers G. Mechanics of psoas tendon snapping. A virtual population study. Front Bioeng Biotechnol 2020; 8: 264.
[15]
Morris WZ, Fowers CA, Weinberg DS, Millis MB, Tu LA, Liu RW. Hip morphology predicts posterior hip impingement in a cadaveric model. Hip Int 2019; 29(3): 322-7.
[http://dx.doi.org/10.1177/1120700018779906] [PMID: 29808721]
[16]
Vicentini JRT, Martinez-Salazar EL, Simeone FJ, Bredella MA, Palmer WE, Torriani M. Kinematic MRI of ischiofemoral impingement. Skeletal Radiol 2021; 50(1): 97-106.
[http://dx.doi.org/10.1007/s00256-020-03519-4] [PMID: 32638058]
[17]
Kheterpal AB, Harvey JP, Husseini JS, Martin SD, Torriani M, Bredella MA. Hip abductor tears in ischiofemoral impingement. Skeletal Radiol 2020; 49(11): 1747-52.
[http://dx.doi.org/10.1007/s00256-020-03497-7] [PMID: 32514583]
[18]
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33(1): 159-74.
[http://dx.doi.org/10.2307/2529310] [PMID: 843571]
[19]
Wilson MD, Keene JS. Treatment of ischiofemoral impingement: results of diagnostic injections and arthroscopic resection of the lesser trochanter. J Hip Preserv Surg 2016; 3(2): 146-53.
[20]
Maraş Özdemir Z, Aydıngöz Ü, Görmeli CA, Sağır Kahraman A. Ischiofemoral space on MRI in an asymptomatic population: normative Wwidth measurements and soft tissue signal variations. Eur Radiol 2015; 25(8): 2246-53.
[http://dx.doi.org/10.1007/s00330-015-3625-3] [PMID: 25680726]
[21]
Singer A, Clifford P, Tresley J, Jose J, Subhawong T. Ischiofemoral impingement and the utility of full-range-of-motion magnetic resonance imaging in its detection. Am J Orthop 2014; 43(12): 548-51.
[PMID: 25490008]
[22]
O’Brien SD, Bui-Mansfield LT. MRI of quadratus femoris muscle tear: another cause of hip pain. AJR Am J Roentgenol 2007; 189(5): 1185-9.
[http://dx.doi.org/10.2214/AJR.07.2408] [PMID: 17954659]
[23]
Gómez-Hoyos J, Schröder R, Reddy M, Palmer IJ, Martin HD. Femoral neck anteversion and lesser trochanteric retroversion in patients with ischiofemoral impingement: A case-control magnetic resonance imaging study. Arthroscopy 2016; 32(1): 13-8.
[http://dx.doi.org/10.1016/j.arthro.2015.06.034] [PMID: 26358634]
[24]
Akça A, Şafak KY, İliş ED, Taşdemir Z, Baysal T. Ischiofemoral impingement: assessment of mri findings and their reliability. Acta Ortop Bras 2016; 24(6): 318-21.
[http://dx.doi.org/10.1590/1413-785220162406162686] [PMID: 28924358]
[25]
Liu RW, Toogood P, Hart DE, Davy DT, Cooperman DR. The effect of varus and valgus osteotomies on femoral version. J Pediatr Orthop 2009; 29(7): 666-75.
[http://dx.doi.org/10.1097/BPO.0b013e3181b769b5] [PMID: 20104143]
[26]
Stenhouse G, Kaiser S, Kelley SP, Stimec J. Ischiofemoral impingement in children: Imaging with clinical correlation. AJR Am J Roentgenol 2016; 206(2): 426-30.
[http://dx.doi.org/10.2214/AJR.15.14909] [PMID: 26587798]
[27]
Park S, Lee HY, Cuong PM, et al. Supine versus standing radiographs for detecting ischiofemoral impingement: A propensity score-Matched analysis. AJR Am J Roentgenol 2016; 206(6): 1253-63.
[PMID: 27070951]
[28]
Finnoff JT, Bond JR, Collins MS, et al. Variability of the ischiofemoral space relative to femur position: An ultrasound study. PM R 2015; 7(9): 930-7.
[PMID: 25772723]
[29]
Kivlan BR, Martin RL, Martin HD. Ischiofemoral impingement: defining the lesser trochanter-ischial space. Knee Surg Sports Traumatol Arthrosc 2017; 25(1): 72-6.
[PMID: 26869034]
[30]
Johnson AC, Hollman JH, Howe BM, Finnoff JT. Variability of ischiofemoral space dimensions with changes in hip flexion: an MRI study. Skeletal Radiol 2017; 46(1): 59-64.
[http://dx.doi.org/10.1007/s00256-016-2508-2] [PMID: 27738747]
[31]
Kassarjian A, Tomas X, Cerezal L, Canga A, Llopis E. MRI of the quadratus femoris muscle: anatomic considerations and pathologic lesions. AJR Am J Roentgenol 2011; 197(1): 170-4.
[http://dx.doi.org/10.2214/AJR.10.5898] [PMID: 21701027]

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