Application Of MR To Explore Clinical Trial Mechanism Of Ischiofemoral Impingement And IFS Influencing Factors

Part 1 Hip joint triaxial dynamic MR interpretation Clinical trial of ischi-femoral impingement0bjective:To explore the dynamic changes of ischiofemoral space under triaxial movement of hip joint,to verify the mechanism of clinical specific tests(Ischiofemoral impingement test and long-stride walking test),and to further study the pathogenesis of ischiofemoral impingement syndrome.Methods:In a prospective design,67 hips of 37 patients with clinically diagnosed IFI and 69 hips of 39 normal controls were selected.The simulated IFI impact test was designed for dynamic MR examination(adduction,internal rotation30 °,adduction position and external rotation 30 °,supine position flexion 30 °,prone position extension 30 °).The IFS and QFS were measured in different positions.Results:37 patients,28 females and 9 males in the case group were included in67 hips,while 39 in the control group,24 females and 15 males,with a total of 69 hips,and the case group had IFS adduction,internal rotation30 °,adduction position and external rotation 30 °,supine position and flexion30 °,prone position and extension 30 °:12.62 ± 4.07 mm,25.12 ±6.42 mm,11.16 ± 3.15 mm,47.31 ± 5.97 mm,9.06 ± 3.33mm;Control group:21.20 ± 4.92 mm,34.67 ± 6.71 mm,17.42 ± 5.30 mm,53.60 ±6.74 mm,15.64±4.21mm;The case group had QFS adduction,internal rotation30 °,adduction and external rotation 30 °,supine flexion 30 °,prone extension30 °:8.66±3.04 mm,17.37±4.60 mm,7.97±3.01 mm,33.40±5.56 mm,5.21± 2.74mm;Control group:14.64 ± 3.87 mm,23.41 ± 4.46 mm,12.55 ±4.38 mm,38.72±8.14 mm,11.14±3.58 mm.There were significant differences in IFS and QFS between the case group and the control group(p< 0.05).The IFS and QFS of the case group were smaller than those of the control group.There were differences in IFS and QFS in different positions in the group(p <0.05).IFS and QFS were significantly reduced in prone extension,adduction and external rotation position of hip joint.The areas under the ROC curve of supine adduction position and prone extension position were more than 0.9,which showed high sensitivity and specificity.The correlation coefficients between IFI test,LSW test and IFS were-0.621 and-0.715,and the correlation coefficients with QFS were-0.653 and-0.696.Conclusions:1 The results of the study show that the IFS and QFS of the IFI case group in the same position are smaller than those of the control group.There are differences in IFS and QFS in different positions in the group.IFS and QFS are affected by the three-axis motion position of the patient’s hip joint.Adduction and external rotation IFS and QFS were significantly reduced,and hip flexion,abduction and internal rotation IFS and QFS were significantly increased.2 The results verified the IFI clinical specific examination IFI test and the LSW test mechanism,when the hip joint is actively or passively extended,adducted and externally rotated,it causes IFS stenosis and impacts the quadratus femoris muscle,Induced positive symptoms,and when the hip joint was flexed,abducted and internally rotated,the symptoms were relieved due to the widening of IFS.Three-axis motion imaging of the hip joint provides dynamic imaging basis for IFI clinical specific trials.Part 2 Correlation analysis between ischiofemoral space and FNV、LTV、LTFNAPurpose:To quantify the femoral neck version(FNV),the lesser trochanteric version(LTV))and the angle between lesser trochanter and femoral neck(LTFNA),to explore their effects on the ischiofemoral space(IFS),and to further study the anatomic susceptibility factors related to ischiofemoral impingement syndrome(IFI).Methods:A total of 129 hips in 67 patients with IFI were collected,and 69 normal volunteers with 138 hips as the control group were scanned by MR,FNV、LTV and LTFNA were measured with the three-dimensional fusion software of GEAW4.7 workstation,the connecting line of the surface of the posterior condyle of femur as the reference line.Measure and calculate FNV,LTV,LTFNA,IFS were measured on PD-FS axis picture.The data conformed to the normal distribution,and the two independent sample t-tests were used to compare the FNV,LTV,LTFNA,IFS values of the case group and the control group;the correlation between FNV,LTV,LTFNA and IFS was analyzed by Pearson correlation(p<0.05).Results:A total of 67 patients with 129 hips(22 males and 107 females)were included in the case group,with an average age of 53.11 ±10.5 years(range,29 to 73 years),and 69 patients in the control group,138 hips(50 males and88 females),The average age was 47.46 ±11.4 years(range 26 to 67 years).The values of FNV,LTV,LTFNA and IFS in the case group were 18.16±10.47 °,-19.26 ±10.70 °,37.50 ±12.79 °and 13.1 ±1.64 mm.In the control group,FNV,LTV,LTFNA and IFS were 13.87 ±7.72 °,-19.83 ±9.48 °,33.69±11.99 °and 24.0 ±1.49 mm.There was significant difference in FNV,LTFNA and IFS between the two groups,but there was no significant difference in LTV between the two groups(p> 0.05).The correlation coefficients between FNV,LTFNA and IFS were-0.62 and-0.58,showing a moderate negative correlation.The correlation coefficient between LTV and IFS was-0.32,showing a weak correlation.Conclusions:IFS in the ischiofemoral impingement group is significantly smaller than that in the control group,while FNV and LTFNA are significantly larger than those in the control group.There is a negative correlation between FNV,LTFNA and IFS,and there is a weak correlation between LTV and IFS.FNV and LTFNA are important morphological factors related to the occurrence of IFI.