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Age / Sex : 48 / F
Age / Sex :
48/Female
Chief complaint :
Hip pain, both sides
Left hip showed more severe symptoms than right side
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of
this case.
* Send Application Answers to In Sook Lee, MD (lis@pusan.ac.kr)
Courtesy : Kyung Jin Suh,
Dongguk University, College of Medicine Gyungju
Hospital
Diagnosis: Ischiofemoral Impingement, both
Discussion
Findings:
48-year-old
women with axial MR images through lesser trochanter show narrowing of both
ischiofemoral space and quadratus femoris space.
There
reveals impingement with muscle edema of both quadratus femoris muscle.
Differential
Diagnosis:
Quadratus
femoris muscle myotendinous strains, or partial tears
Diagnosis:
Ischiofemoral
Impingement, both
Discussion:
Impingement of the quadratus femoris
muscle is best seen on axial images, on which the location of the
edema can be accurately localized. In addition, axial images
facilitate assessment of the relation between the muscle belly and
the surrounding structures. An article reported the correlation
a narrowed distance between the ischial tuberosity and the lesser trochanter
and impingement of the quadratus femoris. For the differentiation of the strain
and impingement of the quadratus femoris muscle, evaluation of the
location of edema and the configuration of the muscle fibers and
surrounding structures can help in differentiating the two entities.
References:
Torriani M, Souto SC, Thomas BJ,
Ouellette H and Bredella MA. Ischiofemoral impingement syndrome: an entity with
hip pain and abnormalities of the quadratus femoris muscle. AJR 2009;
193:186–190
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
Ara Kassarjian, Xavier Tomas, Luis
Cerezal, Ana Canga, and Eva Llopis. MRI of the Quadratus Femoris
Muscle: Anatomic Considerations and
Pathologic Lesions.
AJR 2011; 197:170 -
174
O'Brien SD, Bui-Mansfield LT. MRI of
quadratus femoris muscle tear: another cause of hip pain. AJR 2007;189:1185-1189
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