To give an overview of non-femoroacetabular forms of hip impingement (includingischiofemoral,
anterior inferior iliac spine/subspine and iliopsoas impingement) doing a review of recent literature.
To discuss the role of imaging in the evaluation of atypical forms of hip impingement and illustrate the main radiologic features which will enable us to suggest a more accurate diagnosis.
Femoroacetabular impingement (FAI) is a well known cause of hip pain,
labral tears and early osteoarthritis,
and has been extensively reported in the literature overthe past decade.
The morphological characteristics most commonly associated with FAI include decreased head-neck offset and retroversion of the acetabulum.
in the last few years,
other different forms of hip impingement have been increasingly recognized as a potential cause of hip pain and limited function in young patients.
Thesenon-femoroacetabular impingement syndromesinclude ischiofemoral impingement,
anterior inferior iliac spine/subspine impingement and iliopsoas...
Findings and procedure details
Ischiofemoral impingement is defined by hip pain related to narrowing of the space between the ischial tuberosity-hamstring tendon unit medially and lesser trochanter laterally,
with intermittent compression of the quadratus femoris muscle (QFM) and associated edema,
tears or fatty replacement.
[3,4] Fig. 1
The ischiofemoral narrowing may be positional,
acquired or congenital.
Positional factors that may cause ischiofemoral narrowing include lower extremity internal/external rotation,
Congenital ischiofemoral narrowing causes may include a lower ischiopubic ramus,
prominent lesser trochanter,
larger cross section...
Hip-groin pain is a day-to-day clinical problem,
and it may be due to many causes.
Although less common than classic femoroacetabular impingement,
other atypical forms of hip impingement (includingischiofemoral,
anterior inferior iliac spine/subspine and iliopsoas impingement) have been recently identified as a potential cause of hip pain,
especially in young nonarthritic patients.
Knowledge of their clinical features and radiological findings will enable us to suggest a more specific diagnosis and therefore a more accurate management of these conditions can be achieved.
Semin Musculoskelet Radiol. 2013 Jul;17(3):279-85.
de Sa D,
Extra-articular hip impingement: a systematic review examining operative treatment of psoas,
and greater trochanteric/pelvic impingement.
Arthroscopy. 2014 Aug;30(8):1026-41.
Atypical hip impingement.
AJR Am J Roentgenol.
Magn Reson Imaging Clin N Am. 2013 Feb;21(1):65-73.
Results of labral-level arthroscopic iliopsoas tenotomies for...