Ischiofemoral Impingement Test
Original Editor - Matt Huey
Top Contributors - Matt Huey and Alexandra Stead}
Purpose
Ishiofemoral impingement (IFI) syndrome is when there is narrowed space of the lateral aspect of the ischium and medial aspect of the lesser trochanter which produces a posterior hip pain. This was first described by Dr. Kenneth Johnson in a paper describing patients with pain in their hip after a total hip arthroplasty.[1] He believed it was due to a pinching of soft tissue between the soft tissues of the boney prominences. The test was developed from the original proposed irritating position of hip extension, adduction and external rotation.
Technique
How to perform it:
- Have the patient in a sidelying position with the painful side up
- The examiner supports the lower portion of the patients leg and passively takes the hip into extension. The patient's hip can also be taken into adduction
- If pain is produced with the hip in a neutral or adducted position, take the patient's hip into abduction and assess symptoms
A positive test is if the posterior pain is produced with the hip in neutral or adducted and then the symptoms are relieved when the hip is taken into abduction.
Evidence
The original paper by Gomez-Hoyes et al.[2] looked at 30 individuals with hip pain to which 17 had confirmed IFI syndrome. Utilising this test, researchers found a sensitivity of 82%, specificity of 85%, positive predictive value of 88%, and negative predictive value of 79%.
Little is fully understood about this condition and the diagnosis is challenging. It has been stated the optimal diagnosis is a combination of physical tests and imaging.[3] When it comes to the treatment of IFI syndrome, there is no clear superior treatment. A meta-analysis looking at studies utilising conservative care (physiotherapy, NSAIDs, injections, and prolotherapy) to surgery, did not find one approach superior than the others.[4]
Resources
References
- ↑ Johnson, KA. Impingement of the lesser trochanter on the ischial ramus after total hip arthroplasty. Report of three cases. The Journal of Bone & Joint Surgery 59(2):p 268-269, March 1977.
- ↑ Gómez-Hoyos, J., Martin, R. L., Schröder, R., Palmer, I. J., & Martin, H. D. (2016). Accuracy of 2 clinical tests for ischiofemoral impingement in patients with posterior hip pain and endoscopically confirmed diagnosis. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 32(7), 1279-1284.
- ↑ Wu, W. T., Chang, K. V., Mezian, K., Naňka, O., Ricci, V., Chang, H. C., ... & Özçakar, L. (2022). Ischiofemoral impingement syndrome: clinical and imaging/guidance issues with special focus on ultrasonography. Diagnostics, 13(1), 139.
- ↑ Nakano, N., Shoman, H., & Khanduja, V. (2020). Treatment strategies for ischiofemoral impingement: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 28(9), 2772-2787.