48-year-old female patient was referred for 5 years history of the left hip pain, radiating to lower extremity with a hip snapping sensation

 

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Doctor's Information

Name : morteza
Family : sanei taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Hadi Zolfeghari

 

Case Section

Muskuloskeletal System

 

Patient's Information

Gender : Female
Age : 48

 

Clinical Summary

A 48-year-old female patient was referred for 5 years history of the left hip pain, radiating to lower extremity with a hip snapping sensation. She had no history of trauma or surgery at or around the hip joint and femur. The magnetic resonance imaging (MRI) of the lumbar spine revealed post operative changes at L3-L4 due to same radiating pain.

 

Imaging Findings

Hip MRI revealed quadratus femoris muscle and common hamstring origin edema with concurrent narrowing of the ischiofemoral space. The distance of ischiofemoral space and quadratus femoris space were narrow. It was compatible with ischiofemoral impingement syndrome.

 

Differential Diagnosis

QFM or adductor muscle tear and tendinitis
hamstring injury
snapping hip syndrome
piriformis syndrome
lumbar radiculopathy

 

Final Diagnosis

ischiofemoral impingement syndrome

 

Discussion (Related Text)

Hip pain is a common cause of medical attention and diagnosis is difficult because the etiology is diverse. One of them, little known, is ischiofemoral impingement syndrome. Ischiofemoral impingement syndrome is known as one of the causes of hip pain due to impingement of Quadratus femoris muscle between ischium and femur, and usually correlated with trauma or operation.Quadratus femoris muscle is a flat muscle which has a orgin on the Lateral margin of the obturator ring above ischial tuberosity and insertion on the Quadrate tubercle and adjacent bone of intertrochanteric crest of proximal posterior femur.

 

References

1. Patti JW, Ouellette H, Bredella MA, Torriani M. Impingement of lesser trochanter on ischium as a potential cause for hip pain. Skeletal Radiol. 2008;37:939–941. [PubMed]
2. Johnson KA. Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty: report of three cases. J Bone Joint Surg Am. 1977;59:268–269. [PubMed]
3. Ali AM, Whitwell D, Ostlere SJ. Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skeletal Radiol. 2011;40:653–656. [PubMed]

 

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