Ischio-Femoral Impingment (IFI), a lesser known cause of hip pain, can often be overlooked in patients who present with refractory hip pain. This group of patients often present with the following symptoms: · Non-specific Buttock / Groin Pain · Painful “Popping” / “Snapping” - presumed to be arising from the hip · Pain on the Ischial Spine, with or without radiation Our study aims to raise awareness of IFI amongst both orthopaedic surgeons as well as radiologists, so as to improve its detection on MRIs,...

We reviewed 1290(n=1290)MRI adult pelvic scans performed within a 14-month period, from 1stJune 2016 to 31st July2017, retrospectively. Two teams of dedicated MSK radiologists, working in pairs, achieved inter-observer agreement for all diagnostic scans, based on the following, recognized criteria: 1) Narrowing of the Ischio-Femoral Space (≤15mm) 2) Narrowing of the Quadratus Femoris Space (≤12mm) 3) Atrophy of the Quadratus Femoris Muscle (QFM) 4) Oedema / Signal Changes in the QFM on MRI fluid-sensitive sequences The axial T2 weighted sequences were primarily surveyed, as they...

Of the 1290 MRI pelvic scans, 43patientshad consistent radiological evidence of IFI. All of thempresented withsymptoms consistent with IFI. 35 (k1= 35) were female, and 8 (k2 = 8) were male patients. 14patients had total hip prostheses in-situ. 22patients were accurately diagnosed at initial reporting. Of the remaining21patients, the condition/appearance of the QFM was not commented upon and there was no comment on the ischiofemoral space narrowing. The age distribution ranged from 31 to 92 years of age(median age of 66.5), with predominance of positive...

Our limited study shows a trend of under-diadnosis of IFI across our two Institutions. We believe in most cases, this is due to lack of awareness for this condition in the non-MSK Radiology community. As such, we hope to improve our practice by raising awareness of IFI, as well as including this condition in the reporting check-list on all pelvic scans, irrespective of sub-specialty. By recognizing IFI promptly and accurately, we can facilitate prompt management for affected patients.

1) Ischio-Femoral Impingement Syndrome: An Entity with Hip Pain & Abnormalities of the Quadratus Femoris Muscle. Torriani et al, AmJRoentgenol, 2009;193: 186-90. 2) Case Report: Imaging & Surgical Treatment of a Snapping Hip due to Ischio-Femoral Impingement. Ali AM, Whitwell D, Ostlere SJ, Skeletal Radiology, 2011. 3) Ischio-Femoral Impingement: Evaluation with New MRI Parameters and Assessment of their Reliability. Ozgur Tosun et al, Skeletal Radiology, 2012