Presentation
Left hip pain
Patient Data
PD fat sat sequence demonstrates high signal in the left quadratus femoris muscles, which is extending into the obturator externus, inferior gemellus, and semimembranosus muscles. The changes are most marked at the ischiofemoral space between the ischial tuberosity and the lesser trochanter of femur, which typically measures less than 15 mm. The appearances are in keeping with grade 3 ischiofemoral impingement. Coronal T1 weighted sequence shows linear and globular fatty infiltration involving less than 50% of the muscle bulk of the left quadratus femoris muscle in keeping with grade 2 fatty replacement.
Case Discussion
This is a typical case of ischiofemoral impingement in a middle-aged gentleman. Ischiofemoral impingement is an uncommon cause of hip / inguinal pain caused by acquired or congenital narrowing of the ischiofemoral space (<15 mm) with resultant impingement and edema of quadratus femoris muscle 1. Typically occurs in middle aged/elderly women and is uncommon in males. Various degrees of muscle atrophy may develop in chronic impingement. MRI is required to make a diagnosis by demonstrating muscular edema at the narrowed ischiofemoral space 2.