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Multiple hereditary exostoses and ischiofemoral impingement: a case-control study
Philip Yoong1, Ramy Mansour, James L Teh
1Department of Radiology, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford, OX3 7LD, UK, philipyoong@gmail.com.
Skeletal Radiology
|June 6, 2014
Summary
Patients with multiple hereditary exostoses (MHE) have a significantly reduced ischiofemoral space, increasing the risk of hip pain. This finding suggests MHE can cause ischiofemoral impingement even without severe arthritis.
Area of Science:
- Orthopedics
- Radiology
- Genetics
Background:
- Ischiofemoral impingement is a recognized cause of hip and buttock pain.
- It is characterized by narrowing of the ischiofemoral space and potential abnormalities of the quadratus femoris muscle.
Purpose of the Study:
- To determine if patients with multiple hereditary exostoses (MHE) affecting the proximal femora exhibit a smaller ischiofemoral space compared to healthy individuals.
- To investigate the association between MHE, ischiofemoral space dimensions, and MRI findings suggestive of ischiofemoral impingement.
Main Methods:
- Retrospective analysis of pelvic MRIs from 2006-2013 for individuals with MHE and proximal femoral involvement.
- Age- and sex-matched control group selection.
- Measurement of minimum ischiofemoral space (MIFS) and assessment for quadratus femoris edema/atrophy and hip osteoarthrosis.
Main Results:
- The study included 21 hips in 11 MHE patients and 21 control hips.
- Individuals with MHE showed a significantly smaller mean MIFS (10.7 mm) compared to controls (18.1 mm).
- MRI features suggestive of ischiofemoral impingement were present in 62% of MHE hips versus 0% of control hips.
Conclusions:
- Reduced ischiofemoral space and quadratus femoris abnormalities are common in MHE patients with proximal femoral involvement.
- These findings may explain hip and buttock pain in MHE, even without significant degenerative joint changes.
