Ischiofemoral Impingement: Assessment of Diagnosis through MRI and Physical Examination

Objective: The objective of this study is to assess the precision of physical examination tests in individuals diagnosed with ischiofemoral impingement syndrome (IFI), analyze magnetic resonance imaging (MRI) findings and measurements, and explore the correlation between imaging methods and physical examination tests. Methods: The MRIs of 27 hips of 20 patients who have presented with complaints of hip/groin pain in the study group and 40 hips of 20 patients in the control group were analyzed. Patients were evaluated for the severity of pain, clinical findings, and physical examination tests. Quadratus femoris muscle (QFM) edema was graded and quadratus femoris space (QFS), hamstring tendon area (HTA) and especially ischiofemoral space (IFS), were measured on MRI. Results: Both the IFS (12.44 +/- 3.49) and QFS (6.38 +/- 2.09) were significantly reduced in the study groups compared to the control groups (IFS:23.06 +/- 4.5, p<0.001; QFS:15.36 +/- 4.45, p<0.001). Measurements of the IFS (cut-off:<= 18.58) and the QFS (cut-off:<= 10.27) demonstrated high specificity (87.5%) and sensitivity (100%) in identifying IFI. The long-step walking (LSW) test was positive in 59.3% of cases. Conclusion: The results suggest that MRI is a valuable tool for providing detailed information on various aspects related to IFI. It allows for the assessment of the narrowing of the IFS and QFS, as well as the presence of edema. MRI, when combined with LSW test, can contribute to a comprehensive evaluation and diagnosis of IFI, enabling clinicians to gather important clinical and radiological data for accurate assessment.