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Related Concept Videos

Bones of the Lower Limb: Femur and Patella01:16

Bones of the Lower Limb: Femur and Patella

The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the neck...
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The thigh's motion is primarily governed by muscles originating in the pelvic girdle and inserted into the femur. One crucial muscle, the iliopsoas, is a combination of the psoas major and the iliacus muscles, sharing a common insertion point on the lesser trochanter of the femur.
Three other significant muscles are the gluteus maximus, gluteus medius, and gluteus minimus. The gluteus maximus originates from the posterior surface of the ilium, sacrum, and coccyx, and the thoracolumbar fascia...

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Non-femoroacetabular impingement.

Donna G Blankenbaker1, Michael J Tuite

  • 1Department of Radiology, Clinical Science Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792-3252, USA. dblankenbaker@uwhealth.org

Seminars in Musculoskeletal Radiology
|June 22, 2013
PubMed
Summary

Femoroacetabular impingement and other hip impingement syndromes cause hip pain, potentially leading to early osteoarthritis. Recognizing these conditions, including ischiofemoral, AIIS/subspine, and iliopsoas impingement, aids accurate diagnosis.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Radiology

Background:

  • Femoroacetabular impingement (FAI) is a common cause of hip pain, often leading to labral tears, cartilage damage, and early osteoarthritis.
  • Other recognized causes of hip impingement include ischiofemoral, anterior inferior iliac spine/subspine (AIIS/subspine), and iliopsoas impingement.

Purpose of the Study:

  • To highlight lesser-known causes of hip impingement beyond FAI.
  • To describe the specific mechanisms and clinical presentations of ischiofemoral, AIIS/subspine, and iliopsoas impingement.
  • To emphasize the importance of considering these conditions in the differential diagnosis of hip pain.

Main Methods:

  • Review of current literature and clinical understanding of hip impingement syndromes.
  • Description of the anatomical relationships and pathological findings associated with each type of impingement.
  • Discussion of diagnostic imaging modalities used to evaluate hip pain and exclude intra-articular pathology.

Main Results:

  • Ischiofemoral impingement involves narrowing between the ischial tuberosity and lesser trochanter, affecting the quadratus femoris muscle.
  • AIIS/subspine impingement results from abnormal contact between the AIIS and the proximal femur.
  • Iliopsoas impingement is associated with a thickened or taut iliopsoas tendon impinging on the acetabular rim.

Conclusions:

  • Accurate diagnosis of hip pain requires consideration of various impingement syndromes, not solely FAI.
  • Imaging techniques such as radiographs, MRI, ultrasound, and CT are crucial for diagnosis and excluding other hip pathologies.
  • Awareness of these distinct impingement causes improves diagnostic accuracy for patients with painful hips.