Evaluation Of The Effect Of Relevant Anatomical Structure Of Proximal Femur On Ischiofemoral Impingement Syndrome By MRI

Objective:To investigate the influence of the relevant anatomical structure of proximal femur on ischiofemoral impingement syndrome and to understand the inducing factors of ischiofemoral impingement syndrome.Methods:A retrospective analysis of hip joint MRI was made.42 cases(77hips)of patients with clinical diagnosis of ischiofemoral impingement were treated as the case group and the other 41cases(67hips)who had been excluded of IFI by clinicians were treated as the control group.Ischiofemoral space(IFS),the height and the area of femoral lessor trochanter were measured on axial FS PDWI images;the femoral offset(FO),cervicodiaphyseal angle(CCD),and the length of femoral neck axis(FNAL)were measured on coronal TIWI images.The intraclass correlation coefficient(ICC)was used to test the consistency of three physicians’ measurements.The data of the case group and the control group were normally distributed with homogeneity of variance,and independent sample t test was used.When the data did not conform to the normal distribution,Mann-Whitney U test was used.Gender and age were included,and Multivariate Logistic regression was used to analyze the influencing factors of ischiofemoral impingement syndrome.Results:1.IFS,FO and FNAL in case group were 12.4(10.2-15.0)mm,(26.1±5.9)mm and 84.5(80.5-88.6)mm,while these measurements were 24.0(20.7-26.2)mm,(31.1±5.2)mm and 89.2(84.7-95.2)mm in control group,These measurements were significantly lower in case group than those in control group(P<0.05).The height and area of femora lessor trochanter,CCD in case group were 22.9(20.0-25.4)mm,4.5(3.7-5.4)cm2 and(137.6±5.7)°,while these measurements were 20.9(18.4-22.6)mm,4.0(3.6-4.7)cm2 and(135.4±5.9)° in control group.These measurements were significantly higher in case group than those in control group(P<0.05).2.in the case group,IFS,the height and area of femoral lessor trochanter,FNAL of male were(12.5 ± 2.5)mm,26.4(23.7-27.6)mm,5.4(4.7-5.7)cm2 and 87.1(85.6-91.2)mm.while these measurements of female were(12.5±3.8)mm,20.7(19.2-22.9)mm,4.0(3.4-4.6)cm 2 and 81.9(79.0-86 4)mm.Except the IFS,the height and area of femoral lessor trochanter,FNAL of male were significantly higher than those of female(P<0.05).3.in the control group,IFS,the height and the area of femoral lessor trochanter,FNAL of male were 23.9(21.2-26.3)mm、(22.4±3.6)mm、(4.6±0.9)cm2 and 94.9(90.8-97.1)mm.while these measurements of female were 24.0(20.5-26.0)mm、(19.2±2.7)mm、(3.6±0.7)cm2 and 85.8(82.5-88.6)mm.Except the IFS,the height and area of femoral lessor trochanter,FNAL of male were significantly higher than those of female(P<0.05).4.Multivariate logistic regression analysis shows that age,the height of femoral lessor trochanter,CCD and FNAL were the influencing factors of IFI(P<0.05).Conclusion:Age,the height of femoral lessor trochanter,CCD,and FNAL have more influence on ischiofemoral impingement syndrome than other factors and play an important role in the pathology of ischiofemoral impingement syndrome.