Hip abductor tears in ischiofemoral impingement
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SCIENTIFIC ARTICLE
Hip abductor tears in ischiofemoral impingement Arvin B. Kheterpal 1 & Joel P. Harvey 1 & Jad S. Husseini 1 & Scott D. Martin 2 & Martin Torriani 1 & Miriam A. Bredella 1 Received: 15 April 2020 / Revised: 23 May 2020 / Accepted: 27 May 2020 # ISS 2020
Abstract Purpose Ischiofemoral impingement (IFI) is associated with abnormalities of the quadratus femoris muscle and narrowing of the ischiofemoral (IF) and quadratus femoris (QF) spaces. The hip abductors play an important role in pelvic stability and abductor tears might play a role in the pathophysiology of IFI. The purpose of our study was to assess the association between hip abductor tears and IFI on MRI. Materials and methods The study was IRB approved and HIPAA compliant. Inclusion criteria were MRI findings of IFI (narrowing of the IF space ≤ 15 mm or QF space ≤ 10 mm with associated ipsilateral quadratus femoris edema or fatty infiltration/atrophy). Two MSK radiologists assessed hip/pelvic MRIs and integrity of the tensor fascia lata, gluteus medius, and minimus tendons. IFI and control groups were compared with a two-tailed Student t test or chi-squared test. Results We identified 140 patients with MRI findings of IFI (mean age 56 ± 13 years, 130 f, 10 m) and 140 controls of similar age and sex. Patients with IFI had a higher prevalence of gluteus medius/minimus partial tears (37 vs 21, p = 0.02) and full-thickness tears (24 vs 21, p = 0.03). Patients with IFI had a higher prevalence and higher grade of gluteal muscle atrophy compared with controls (p < 0.03). There were no tears of the tensor fascia lata in either group. Conclusion Patients with IFI had a higher prevalence of abductor tears and abductor muscle atrophy compared with matched controls. This suggests that abductor tears might play a role in the pathophysiology of IFI. Keywords Ischiofemoral impingement . Hip . Abductors . Gluteus medius . Gluteus minimus
Introduction Ischiofemoral impingement (IFI) is due to narrowing of the ischiofemoral (IF) space, the space between the ischial tuberosity and lesser trochanter and/or the quadratus femoris (QF) space, the space between the hamstring origin and lesser trochanter. IFI is typically associated with abnormalities of the quadratus femoris muscle, which can demonstrate edema, partial tear, or fatty infiltration [1, 2].
This study was presented at the Annual Meeting of the Society of Skeletal Radiology in Scottsdale, AZ. * Miriam A. Bredella [email protected] 1
Department of Radiology, Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
2
Sports Medicine, Department of Orthopedic Surgery, Massachusetts General Hospital and Harvard Medical School, 175 Cambridge Street, Boston, MA 02114, USA
IFI occurs more frequently in women and is bilateral in about one-third of cases [2, 3]. Clinical symptoms in IFI can vary but commonly consist of the pain of the lower buttock, groin, and inner thigh. Of note, patients without pain might exh
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