Hip Pelvis.  2018 Dec;30(4):219-225. 10.5371/hp.2018.30.4.219.

Utility of False Profile View for Screening of Ischiofemoral Impingement

• Kwak DK
• Yang IH
• Kim S
• Lee SC
• Park KK
• Lee WS

• KMID: 2427925
• DOI: http://doi.org/10.5371/hp.2018.30.4.219

Abstract

PURPOSE
Ischiofemoral impingement (IFI)-primarily diagnosed by magnetic resonance imaging (MRI)-is an easily overlooked disease due to its low incidence. The purpose of this study was to evaluate the usefulness of false profile view as a screening test for IFI.
MATERIALS AND METHODS
Fifty-eight patients diagnosed with IFI between June 2013 and July 2017 were enrolled in this retrospective study. A control group (n=58) with matching propensity scores (age, gender, and body mass index) were also included. Ischiofemoral space (IFS) was measured as the shortest distance between the lateral cortex of the ischium and the medial cortex of lesser trochanter in weight bearing hip anteroposterior (AP) view and false profile view. MRI was used to measure IFS and quadratus femoris space (QFS). The receiver operating characteristics (ROC), area under the ROC curve (AUC) and cutoff point of the IFS were measured by false profile images, and the correlation between the IFS and QFS was analyzed using the MRI scans.
RESULTS
In the false profile view and hip AP view, patients with IFI had significantly decreased IFS (P < 0.01). In the false profile view, ROC AUC (0.967) was higher than in the hip AP view (0.841). Cutoff value for differential diagnosis of IFI in the false profile view was 10.3 mm (sensitivity, 88.2%; specificity, 88.4%). IFS correlated with IFS (r=0.744) QFS (0.740) in MRI and IFS (0.621) in hip AP view (P < 0.01).
CONCLUSION
IFS on false profile view can be used as a screening tool for potential IFI.

Keyword

Ischiofemoral impingement; False profile view; Ischiofemoral space; Quadratus femoris space

MeSH Terms

Area Under Curve
Diagnosis, Differential
Femur
Hip
Humans
Incidence
Ischium
Magnetic Resonance Imaging
Mass Screening*
Propensity Score
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Weight-Bearing

Figure

• 

  Fig. 1 Diagnosis by magnetic resonance image1). Ischiofemoral space (A) and quadratus femoris space (B) on T2-weighted axial fat-suppressed images on magnetic resonance images as described by Torriani et al6). Iliopsoas tendon (arrowhead), quadratus femoris muscle (straight arrow), and hamstring tendons (curved arrow).

• 

  Fig. 2 Flowchart demonstrating patient selection. MRI: magnetic resonance imaging.

• 

  Fig. 3 Ischiofermoal space on the hip standing anteroposterior (A) and false profile view (B) in 68-year-old woman with left hip pain. The shortest distance between the lateral cortex of the ischial tuberosity and the medial cortex of the lesser trochanter.

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  Fig. 4 Comparison of ischiofemoral space value between false profile and hip anteroposterior view.

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  Fig. 5 Receiver operating characteristics (ROC) curve of each parameter. Graph shows ROC curve of each parameter. Ischiofemoral space (IFS) in magnetic resonance imaging (MRI) and quadratus femoris space (QFS) in MRI are almost same and largest area under the ROC curve (AUC). IFS in hip anteroposterior view (IFSAP) exhibits good discriminatory ability, 0.847 (0.80≤AUC<0.90). IFS in false profile view (IFSFP) has much better discriminatory ability, 0.967 (0.90≤AUC).

• 

  Fig. 6 Cut off value of ischiofemoral space (IFS) in the false profile view. Graph shows sensitivity and specificity values used to discriminate between the study group and the control group. Black curve consisting of triangle shows specificity of IFS in false profile view. Gray curve consisting of circle shows sensitivity of IFS in false profile view. Cut off value was 10.3 mm (sensitivity, 88.6%; specificity, 88.4%). ROC: receiver operating characteristics.

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