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Ischiofemoral Impingement
MK Jesse, MDDonna G. Blankenbaker, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Ischiofemoral impingement (IFI)
              • Synonyms

                • Quadratus femoris (QF) space (QFS) narrowing, ischiofemoral space (IFS) narrowing
              • Definitions

                • Painful compression of QF muscle between ischial tuberosity and lesser trochanter
                • IFS
                  • Distance between ischial tuberosity and medial cortex of lesser trochanter
                • QFS
                  • Distance between superolateral surface of hamstring tendons and posteromedial iliopsoas tendon or lesser trochanter

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Imaging Recommendations

                          • Fluoroscopic Findings

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Nakano N et al: Treatment strategies for ischiofemoral impingement: a systematic review. Knee Surg Sports Traumatol Arthrosc. 28(9):2772-87, 2018
                                                2. Hernando MF et al: Evaluation and management of ischiofemoral impingement: a pathophysiologic, radiologic, and therapeutic approach to a complex diagnosis. Skeletal Radiol. 45(6):771-87, 2016
                                                3. Kim DH et al: Ultrasound-guided quadratus femoris muscle injection in patients with lower buttock pain: novel ultrasound-guided approach and clinical effectiveness. Pain Physician. 19(6):E863-70, 2016
                                                4. Bredella MA et al: Pelvic morphology in ischiofemoral impingement. Skeletal Radiol. 44(2):249-53, 2015
                                                5. Finnoff JT et al: Variability of the ischiofemoral space relative to femur position: an ultrasound study. PM R. 7(9):930-7; quiz 987, 2015
                                                6. Hatem MA et al: Diagnosis and 2-year outcomes of endoscopic treatment for ischiofemoral impingement. Arthroscopy. 31(2):239-46, 2015
                                                7. Maraş Özdemir Z et al: Ischiofemoral space on MRI in an asymptomatic population: normative width measurements and soft tissue signal variations. Eur Radiol. 25(8):2246-53, 2015
                                                8. Singer AD et al: Ischiofemoral impingement syndrome: a meta-analysis. Skeletal Radiol. 44(6):831-7, 2015
                                                9. Backer MW et al: Correlation of ultrasound-guided corticosteroid injection of the quadratus femoris with MRI findings of ischiofemoral impingement. AJR Am J Roentgenol. 203(3):589-93, 2014
                                                10. Kim WJ et al: Ultrasound-guided prolotherapy with polydeoxyribonucleotide sodium in ischiofemoral impingement syndrome. Pain Pract. 14(7):649-55, 2014
                                                11. Yoong P et al: Multiple hereditary exostoses and ischiofemoral impingement: a case-control study. Skeletal Radiol. 43(9):1225-30, 2014
                                                12. Blankenbaker DG et al: Non-femoroacetabular impingement. Semin Musculoskelet Radiol. 17(3):279-85, 2013
                                                13. Ganz R et al: The lesser trochanter as a cause of hip impingement: pathophysiology and treatment options. Hip Int. 23 Suppl 9:S35-41, 2013
                                                14. Taneja AK et al: Ischiofemoral impingement. Magn Reson Imaging Clin N Am. 21(1):65-73, 2013
                                                15. Tosun O et al: Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skeletal Radiol. 41(5):575-87, 2012
                                                16. Ali AM et al: Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skeletal Radiol. 40(5):653-6, 2011
                                                17. Torriani M et al: Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 193(1):186-90, 2009
                                                18. Johnson KA: Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty. Report of three cases. J Bone Joint Surg Am. 59(2):268-9, 1977
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Ischiofemoral impingement (IFI)
                                                            • Synonyms

                                                              • Quadratus femoris (QF) space (QFS) narrowing, ischiofemoral space (IFS) narrowing
                                                            • Definitions

                                                              • Painful compression of QF muscle between ischial tuberosity and lesser trochanter
                                                              • IFS
                                                                • Distance between ischial tuberosity and medial cortex of lesser trochanter
                                                              • QFS
                                                                • Distance between superolateral surface of hamstring tendons and posteromedial iliopsoas tendon or lesser trochanter

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Ultrasonographic Findings

                                                                      • Imaging Recommendations

                                                                        • Fluoroscopic Findings

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Staging, Grading, & Classification

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Nakano N et al: Treatment strategies for ischiofemoral impingement: a systematic review. Knee Surg Sports Traumatol Arthrosc. 28(9):2772-87, 2018
                                                                                              2. Hernando MF et al: Evaluation and management of ischiofemoral impingement: a pathophysiologic, radiologic, and therapeutic approach to a complex diagnosis. Skeletal Radiol. 45(6):771-87, 2016
                                                                                              3. Kim DH et al: Ultrasound-guided quadratus femoris muscle injection in patients with lower buttock pain: novel ultrasound-guided approach and clinical effectiveness. Pain Physician. 19(6):E863-70, 2016
                                                                                              4. Bredella MA et al: Pelvic morphology in ischiofemoral impingement. Skeletal Radiol. 44(2):249-53, 2015
                                                                                              5. Finnoff JT et al: Variability of the ischiofemoral space relative to femur position: an ultrasound study. PM R. 7(9):930-7; quiz 987, 2015
                                                                                              6. Hatem MA et al: Diagnosis and 2-year outcomes of endoscopic treatment for ischiofemoral impingement. Arthroscopy. 31(2):239-46, 2015
                                                                                              7. Maraş Özdemir Z et al: Ischiofemoral space on MRI in an asymptomatic population: normative width measurements and soft tissue signal variations. Eur Radiol. 25(8):2246-53, 2015
                                                                                              8. Singer AD et al: Ischiofemoral impingement syndrome: a meta-analysis. Skeletal Radiol. 44(6):831-7, 2015
                                                                                              9. Backer MW et al: Correlation of ultrasound-guided corticosteroid injection of the quadratus femoris with MRI findings of ischiofemoral impingement. AJR Am J Roentgenol. 203(3):589-93, 2014
                                                                                              10. Kim WJ et al: Ultrasound-guided prolotherapy with polydeoxyribonucleotide sodium in ischiofemoral impingement syndrome. Pain Pract. 14(7):649-55, 2014
                                                                                              11. Yoong P et al: Multiple hereditary exostoses and ischiofemoral impingement: a case-control study. Skeletal Radiol. 43(9):1225-30, 2014
                                                                                              12. Blankenbaker DG et al: Non-femoroacetabular impingement. Semin Musculoskelet Radiol. 17(3):279-85, 2013
                                                                                              13. Ganz R et al: The lesser trochanter as a cause of hip impingement: pathophysiology and treatment options. Hip Int. 23 Suppl 9:S35-41, 2013
                                                                                              14. Taneja AK et al: Ischiofemoral impingement. Magn Reson Imaging Clin N Am. 21(1):65-73, 2013
                                                                                              15. Tosun O et al: Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skeletal Radiol. 41(5):575-87, 2012
                                                                                              16. Ali AM et al: Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skeletal Radiol. 40(5):653-6, 2011
                                                                                              17. Torriani M et al: Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 193(1):186-90, 2009
                                                                                              18. Johnson KA: Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty. Report of three cases. J Bone Joint Surg Am. 59(2):268-9, 1977