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Type:
Educational Exhibit
Keywords:
Athletic injuries, Diagnostic procedure, Education, MR, CT, Conventional radiography, Musculoskeletal soft tissue, Musculoskeletal joint
Authors:
N. Arevalo, E. Diez, J. Gredilla Molinero, A. Munoz Hernandez, M. Grande Barez, E. Roa; Madrid/ES
DOI:
10.1594/ecr2015/C-0229
Background
Femoroacetabular impingement (FAI) is a well known cause of hip pain,
labral tears and early osteoarthritis,
and has been extensively reported in the literature over the past decade.
The morphological characteristics most commonly associated with FAI include decreased head-neck offset and retroversion of the acetabulum.
However,
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.
These non-femoroacetabular impingement syndromes include ischiofemoral impingement,
anterior inferior iliac spine/subspine impingement and iliopsoas impingement.
It is important to diagnose these conditions in order to prevent improper and unnecessary treatments.
[1,2,3]
Ischiofemoral impingement is due to narrowing of the space between the ischial tuberosity medially and femoral lesser trochanter laterally,
with abnormal morphology and/or magnetic resonance imaging signal intensity of quadratus femoris mucle (QFM).
[4]
Anterior inferior iliac spine or subspine impingement is attributed to abnormal contact between the distal femoral neck and a prominent anterior inferior iliac spine (AIIS) with straight hip flexion.
[1,2]
Iliopsoas impingement represents a distinct etiology for acetabular labral tears at the atypical anterior location (3 o’clock position),
where the iliopsoas tendon crosses the acetabular rim.
[5]
The etiology,
clinical presentation,
diagnostic criteria and treatment options for these atypical forms of extra-articular hip impingement are sparsely reported and further validation of clinical and radiologic diagnostic criteria are needed.
[1,2,3]
The current clinical concepts and the most common imaging findings are summarized in this presentation.