Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability
- 1.3k Downloads
The aim of this study was to describe the magnetic resonance imaging (MRI) findings in patients with ischiofemoral impingement (IFI) and to evaluate the reliability of these MRI findings.
Materials and methods
Seventy hips of 50 patients with hip pain and quadratus femoris muscle (QFM) edema and 38 hips of 30 control cases were included in the study. The QFM edema and fatty replacement were assessed visually. Ischiofemoral space (IFS), quadratus femoris space (QFS), inclination angle (IA), hamstring tendon area (HTA), and total quadratus femoris muscle volume (TQFMV) measurements were performed independently by two musculoskeletal radiologists. The intra- and interobserver reliabilities were obtained for quantitative variables.
IFS, QFS, and TQFMV values of the patient group were significantly lower than those of controls (P < 0.001). HTA and IA measurements of the patient group were also significantly higher than in controls (P < 0.05). The QFM fatty replacement grades were significantly higher in the patient group than in the control group (P < 0.001). Inter- and intra-observer reliabilities were strong for all continuous variables.
Clinicians and radiologists should be aware of IFI in patients with hip or groin pain, and MRI should be obtained for the presence of the QFM edema/fatty replacement, narrowing of the IFS-QFS, and other features that may help in the clinical diagnosis of IFI for the proper diagnosis and treatment of the disease.
KeywordsHip pain MRI Quadratus femoris muscle Impingement Ischium Hip
The authors acknowledge Dr. Gokce Akgunduz for drawing of images, Mr. Yasar Ozkaya (Computer Engineer) for contribution in calculation of muscle volumes.
Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Manaster BJ, Roberts CC, Andrews CL, Petersilge CA, Crim J, Rosenberg ZS, et al. In: Manaster BJ, editor. Diagnostic and surgical imaging anatomy: musculoskeletal. 1st ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 64–130.Google Scholar
- 5.Netter FH. Atlas of human anatomy. 2nd ed. King of Prussia, PA: Rittenhouse; 1997. Google Scholar
- 8.Ali AM, Whitwell D, Ostlere SJ. Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skeletal Radiol. 2011. doi: 10.1007/s00256-010-1085-z.
- 15.Chaitow L, DeLany JW. Clinical applications of neuromuscular techniques: the lower body. Edinburgh: Churchill Livingstone Elsevier Science; 2002. p. 394–441.Google Scholar
- 16.Keats TE, Sistrom C. Axial relationships of the hip joint. In: Keats TE, Sistrom C. Atlas of radiologic measurement. 7th ed. St. Louis: Mosby; 2001. pp 238–253.Google Scholar