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Published in: Skeletal Radiology 11/2018

01-11-2018 | Scientific Article

Narrowing of ischiofemoral and quadratus femoris spaces in pediatric ischiofemoral impingement

Authors: Shlomit Goldberg-Stein, Avi Friedman, Qi Gao, Jaeun Choi, Jacob Schulz, Eric Fornari, Benjamin Taragin

Published in: Skeletal Radiology | Issue 11/2018

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Abstract

Objective

To correlate MRI findings of quadratus femoris muscle edema (QFME) with narrowing of the ischiofemoral space (IFS) and quadratus femoris space (QFS) in children, and to identify threshold values reflecting an anatomic architecture that may predispose to ischiofemoral impingement.

Materials and methods

A case-control retrospective MRI review of 49 hips in 27 children (mean, 13 years) with QFME was compared to 49 hips in 27 gender and age-matched controls. Two radiologists independently measured IFS and QFS. Generalized linear mixed-effects models were fit to compare IFS and QFS values between cases and controls, and adjust for correlation in repeated measures from the same subject. Receiver operating characteristic (ROC) analysis determined optimal threshold values.

Results

Compared to controls, cases had significantly smaller IFS (p < 0.001, both readers) and QFS (reader 1: p < 0.001; reader 2: p = 0.003). When stratified as preteen (< 13) or teenage (≥ 13), lower mean IFS and QFS were observed in cases versus controls in both age groups. Area under ROC curve for IFS and QFS was high in preteens (0.77 and 0.71) and teens (0.94 and 0.88). Threshold values were 14.9 mm (preteens) and 19 mm (teens) for IFS and 11.2 mm (preteens) and 11.1 mm (teens) for QFS. IFS and QFS were modestly correlated with age among controls only.

Conclusions

Pediatric patients with QFME had significantly narrower QFS and IFS compared with controls. IFS and QFS were found to normally increase in size with age. Optimal cutoff threshold values were identified for QFS and IFS in preteens and teenagers.
Literature
1.
go back to reference 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(2):268–9.CrossRef 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(2):268–9.CrossRef
2.
go back to reference Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 2009;193(1):186–90.CrossRef Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 2009;193(1):186–90.CrossRef
3.
go back to reference Tosun O, Algin O, Yalcin N, Cay N, Ocakoglu G, Karaoglanoglu M. Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skelet Radiol. 2012;41(5):575–87.CrossRef Tosun O, Algin O, Yalcin N, Cay N, Ocakoglu G, Karaoglanoglu M. Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skelet Radiol. 2012;41(5):575–87.CrossRef
4.
go back to reference Singer AD, Subhawong TK, Jose J, Tesley J, Clifford PD. Ischiofemoral impingement syndrome: a meta-analysis. Skelet Radiol. 2015;44(6):831–7.CrossRef Singer AD, Subhawong TK, Jose J, Tesley J, Clifford PD. Ischiofemoral impingement syndrome: a meta-analysis. Skelet Radiol. 2015;44(6):831–7.CrossRef
5.
go back to reference Stenhouse G, Kaiser S, Kelley SP, Stimec J. Ischiofemoral impingement in children: imaging with clinical correlation. AJR. 2016;206:426–30.CrossRefPubMed Stenhouse G, Kaiser S, Kelley SP, Stimec J. Ischiofemoral impingement in children: imaging with clinical correlation. AJR. 2016;206:426–30.CrossRefPubMed
6.
go back to reference Tosun O, Cay N, Bozkurt M, Arslan H. Ischiofemoral impingement in an 11-year –old girl. Diagn Interv Radiol. 2012;18(6):571–3. Tosun O, Cay N, Bozkurt M, Arslan H. Ischiofemoral impingement in an 11-year –old girl. Diagn Interv Radiol. 2012;18(6):571–3.
7.
go back to reference Truong WH, Murnaghan M, Hopyn S, Kelley SP. Ischioplasty for femoroischial impingement. JBJS Case Connect. 2012;26:2. Truong WH, Murnaghan M, Hopyn S, Kelley SP. Ischioplasty for femoroischial impingement. JBJS Case Connect. 2012;26:2.
8.
go back to reference Ali AM, Whitwell D, Ostlere SJ. Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skelet Radiol. 2011;40(5):653–6.CrossRef Ali AM, Whitwell D, Ostlere SJ. Case report: imaging and surgical treatment of a snapping hip due to ischiofemoral impingement. Skelet Radiol. 2011;40(5):653–6.CrossRef
9.
go back to reference Dong C, Nowakowski AM, Kreig AH. Bilateral ischiofemoral impingement: a case report and literature review. J Ortho Bone Disord. 2017;1(4):0000120. Dong C, Nowakowski AM, Kreig AH. Bilateral ischiofemoral impingement: a case report and literature review. J Ortho Bone Disord. 2017;1(4):0000120.
10.
go back to reference Hernando MF, Cerezal L, Perez-Carro L, Abascal F, Canga A. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space. Skelet Radiol. 2015;44(7):919–34.CrossRef Hernando MF, Cerezal L, Perez-Carro L, Abascal F, Canga A. Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space. Skelet Radiol. 2015;44(7):919–34.CrossRef
11.
go back to reference Bredella MA, Azevedo DC, Oliviera AL, Simeone FJ, Chang CY, Stubbs AJ, et al. Pelvic morphology in ischiofemoral impingement. Skelet Radiol. 2015;44(2):249–53.CrossRef Bredella MA, Azevedo DC, Oliviera AL, Simeone FJ, Chang CY, Stubbs AJ, et al. Pelvic morphology in ischiofemoral impingement. Skelet Radiol. 2015;44(2):249–53.CrossRef
12.
go back to reference Taneja AK, Bredella MA, Ischiofemoral Impingement TM. Magn Reson Imaging Clin N Am. 2013;21:65–73.CrossRefPubMed Taneja AK, Bredella MA, Ischiofemoral Impingement TM. Magn Reson Imaging Clin N Am. 2013;21:65–73.CrossRefPubMed
13.
go back to reference Singer A, Clifford P, Tesley J, Jose J, Subhawong T. Ischiofemoral impingement and the utility of full range of motion MRI in its detection. Am J Orthop. 2014;43(12):548–51.PubMed Singer A, Clifford P, Tesley J, Jose J, Subhawong T. Ischiofemoral impingement and the utility of full range of motion MRI in its detection. Am J Orthop. 2014;43(12):548–51.PubMed
14.
go back to reference Ozdemir ZM, Aydingoz U, Goremeli CA, Kahraman AS. Ischiofemoral space on MRI in an asymptomatic population: normative width measurements and soft tissue signal variations. Eur Radiol. 2015;25:2246–53.CrossRef Ozdemir ZM, Aydingoz U, Goremeli CA, Kahraman AS. Ischiofemoral space on MRI in an asymptomatic population: normative width measurements and soft tissue signal variations. Eur Radiol. 2015;25:2246–53.CrossRef
15.
go back to reference Papavasiliou A, Siatras T, Bintoudi A, Milosis D, Lallas V, Sykaras E, et al. The gymnasts’ hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes. Skelet Radiol. 2014;43:1071–7.CrossRef Papavasiliou A, Siatras T, Bintoudi A, Milosis D, Lallas V, Sykaras E, et al. The gymnasts’ hip and groin: a magnetic resonance imaging study in asymptomatic elite athletes. Skelet Radiol. 2014;43:1071–7.CrossRef
Metadata
Title
Narrowing of ischiofemoral and quadratus femoris spaces in pediatric ischiofemoral impingement
Authors
Shlomit Goldberg-Stein
Avi Friedman
Qi Gao
Jaeun Choi
Jacob Schulz
Eric Fornari
Benjamin Taragin
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 11/2018
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-018-2962-0

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