| Objective: Ischiofemoral impingement syndrome is one of the common clinical causes of hip pain.It is a disease in which the soft tissue is squeezed and clinical symptoms occur because of the narrow distance between the ischium nodule and the lesser trochanter of femur.But the clinical diagnosis is lack of specificity.The purpose of this study is to explore the changes of the femoral space in different positions,to propose the best diagnostic threshold,to observe whether the degree of stenosis is related to the clinical symptoms,to provide better imaging evidence for accurate diagnosis of inschiofemoral impingement syndrome.Methods:1.Forty-three patients with inschiofemoral impingement syndrome(86hip joints)diagnosed by clinic and MRI and 82 healthy volunteers(164 hip joints)were collected,and the pain scores were graded,and different age groups were graded.2.Siemens & GE superconducting MRI was used to scan the standard posture of hip joint and the external rotation of both feet about 0 °,30 °,and60 °positions of hip joint.The images were transmitted to work-station.Two doctors who were engaged in the diagnosis of osteoarthrosis for 10 years and more than 10 years,separately measured the ischiofemoral space and quadratus femoris space and the grade of quadratus femoris edema.3.SPSS17.0 was used to data analysis.A.ICC test was performed on all the data measured by two physicians.B.With respect to the comparison of the IFS and QFS spacing between the case group and the control group in different positions,sex and sides,two independent t-test samples were used.C.The receiver operating characteristic curettes were used to evaluate the accuracy of IFI,and the critical value cutoffvalue.D.The paired t-test was used to compare the IFS and QFS spacing of the control group in different age groups and different postures,respectively.E.Grouping by the clinical pain degree,the independent t test was used in comparison of IFS and QFS of each group.F.To analyze the correlation between the clinical pain grade and the degree of edema of the quadratus femoris muscle.Results:1.There were 43 cases in the group of cases,37 women(about 86%),and6 men(about 14%).2.There was no significant difference in IFS width and QFS width between left and right postures in control group in different positions(P>0.05),3.There was no significant difference in IFS and QFS width of left and right IFS in different postures in patient group(P> 0.05).4.There was significant difference in the width of IFS between the control group and the case group(P< 0.05),and the width of IFS decreased with the increase of the external rotation angle.There was significant difference in the width of QFS between the control group and the case group(P<0.05),and the width of QFS decreased with the increase of the external rotation angle.5.The diagnostic cutoff values of IFS and QFS at neutral position(about0 degree)were 2.06 cm and 1.38 cm.The sensitivity,specificity and area under the ROC curve were 51.63%,75.61%,0.743 and 70.93%,78.93%,0.821.The diagnostic cutoff values of IFS and QFS at external rotation 30°were 1.65 cm and 1.37 cm.The sensitivity,specificity and area under the ROC curve were 56.98%,84.15%,0.737 and 80.23%,64.63%,0.800.The diagnostic cutoff values of IFS and QFS at external rotation 60 ° were 1.78 cm and 1.12 cm.The sensitivity,specificity and area under the ROC curve were77.91%,67.68%,0.775 and 69.77%,76.22%,0.785.6.The widths of IFS in different positions of male and female hip joints were :(2.97±0.84)cm and(2.47±0.85)cm in neutral position 0 °,(2.60±0.71)cm and(2.05±0.74)cm in external rotation 30°,(2.40±0.61)cm and(1.82±0.63)cm in external rotation 60°.The width of QFS in different positions of male and female hip joints ware:(2.20±0.62)cm and(1.57±0.54)cm in neutral position 0°,(1.93±0.50)cm and(1.27±0.37)cm in external rotation30°,(1.78±0.44)cm and(1.18±0.35)cm in external rotation 60°.There were significant differences between male and female hip joints(P< 0.05).The width of IFS and QFS decreased gradually with the increase of external rotation angle.7.In the control group(neutral position 0°),there was significant difference in IFS width between 20-40 age group and 41-60 age group(P < 0.05).In the control group(neutral position 0°),there was significant difference in IFS width between 20-40 age group and over 60 age group(P< 0.05).In the control group(neutral position 0°),there was no difference in IFS width between 41-60 age group and over 60 age group(P>0.05).In the control group(neutral position 0°),there was significant difference in QFS width between 20-40 age group and 41-60 age group(P< 0.05).In the control group(neutral position 0°),there was no difference in QFS width between 20-40 age group and over 60 age group(P>0.05).In the control group(neutral position 0°),there was significant difference in IFS width between 41-60 age group and over 60 age group(P>0.05).The width of IFS decreased gradually with the increase of age.8.There was no significant difference between clinical pain and the width of IFS and QFS.9.There was a positive correlation between the edema of quadratus femoris and clinical pain.Conclusion:1.The best diagnostic value of ischiofemoral impingement syndrome is the IFS distance of 60°external rotation of the two feet,and the critical value for diagnosis is 1.78 cm.2.The width of IFS and QFS in male is wider than those in female.The prevalence of IFI in women was significantly higher than that in male.3.There was no significant difference in IFS and QFS spacing between different sides.4.There were significant differences between 20-40 years old age group and 41-60 years old age group or over 60 years old age group.There were significant differences between 20-40 years old age group and 41-60 years old age group.The width of IFS decreased gradually with the increase of age.5.There was no significant difference between the clinical symptoms and the degree of space stenosis.6.There was a positive correlation between clinical symptoms and the degree of edema of quadratus femoris. |
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