1
|
Jeyaraman M, Murugan J, Maffulli N, Jeyaraman N, Potty AG, Gupta A. Ischiofemoral impingement syndrome: a case report and review of literature. J Orthop Surg Res 2022; 17:393. [PMID: 35986379 PMCID: PMC9392291 DOI: 10.1186/s13018-022-03287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The etiology of ischiofemoral impingement (IFI) syndrome, an unusual and uncommon form of hip pain, remains uncertain. Some patients demonstrate narrowing of the space between the ischial tuberosity and lesser trochanter from trauma or abnormal morphology of the quadratus femoris muscle. Combined clinical and imaging aid in the diagnosis.
Case report A 32-year-old female presented with a 3 years history of pain over the lower aspect of the right buttock, aggravated by movements of the right hip, and partially relieved with rest and medications. The right hip showed extreme restriction of abduction and external rotation. MRI of the right hip showed reduced ischiofemoral space and quadratus femoris space when compared to the left hip. The patient underwent endoscopic resection of the right lesser trochanter, with no recurrence of pain at 2 years.
Conclusion An unusual cause of hip pain, IFI syndrome, should be suspected when hip pain at extremes of movement is associated with signal abnormality of quadratus femoris muscle. Management is tailored to address the inciting factors that precipitated the IFI syndrome.
Collapse
|
2
|
Elafram R, Ben Romdhane M, Khessairi N, Hamdi A. Case Report: Synchronous bilateral lipoma arborescens of the bicipitoradial bursa. F1000Res 2022; 11:787. [PMID: 38433998 PMCID: PMC10907874 DOI: 10.12688/f1000research.122432.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 03/05/2024] Open
Abstract
Background: Lipoma arborescens (LA) is an infrequent benign tumor made of mature sub-synovial fatty cell proliferation that may arise into the synovial joint, the bursae or the tendon sheaths. This condition affects mainly the knee joint, but the bicipitoradial bursa is an exceptional location. We report herein a case of a synchronous bilateral (LA) of the bicipitoradial bursa. Case presentation: A 52-year-old patient, with no medical history, presented with a swelling of both front arms that had been progressing for nine years. Physical examination showed a mass in the antecubital fossae of 3cm on the left side and 0.5cm on the right side. Both masses were tender, well-defined, fixed, without inflammatory signs and painful on elbow flexion. A magnetic resonance imaging (MRI) scan was performed, revealing the presence of a septate soft-tissue mass of the distal portion of the brachial muscle of 70x46x27mm. This mass had a heterogeneous fat signal in its depth and a homogeneous fat composition on the outside. The diagnosis of liposarcoma was suspected. The patient underwent surgery to remove both masses. Gross examination showed a characteristic frond-like or digitiform pattern. Microscopical examination demonstrated papillary proliferation of the synovial villi. The final diagnosis was of LA. The patient had no complications and there was no recurrence of LA. Conclusions: LA is a rare condition, and the bicipitoradial bursa is an exceptional location. Histological confirmation is mandatory to correct the diagnosis.
Collapse
Affiliation(s)
- Rafik Elafram
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| | - Majdi Ben Romdhane
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| | - Nayssem Khessairi
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| | - Ahmed Hamdi
- Homeland Security Forces Hospital, Tunis Elmanar University, La Marsa, 2074, Tunisia
| |
Collapse
|
3
|
Savvidou O, Papakonstantinou O, Lakiotaki E, Zafeiris I, Melissaridou D, Korkolopoulou P, Papagelopoulos PJ. Surface bone sarcomas: an update on current clinicopathological diagnosis and treatment. EFORT Open Rev 2021; 6:905-917. [PMID: 34760290 PMCID: PMC8559567 DOI: 10.1302/2058-5241.6.210064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Surface bone sarcomas are rare malignant bone tumours. Osseous and cartilaginous surface bone sarcomas are the most common, with parosteal and periosteal osteosarcomas, periosteal chondrosarcomas and secondary peripheral chondrosarcomas being the most frequent. Their clinical symptoms are non-specific and include pain for several months, swelling and limited range of motion of the adjacent joints. Prompt diagnosis is important, as biological behaviour, imaging and histopathologic characteristics, treatment and prognosis differ considerably from their conventional intramedullary counterparts. Moreover, their imaging characteristics are not infrequently non-characteristic and may be misinterpreted as juxtacortical benign lesions leading to incorrect diagnosis and treatment, with life-threatening repercussions. Molecular studies and histopathological sampling are essential for accurate diagnosis. There are still numerous issues regarding the biology, pathophysiology and treatment options of these entities due to their rarity.
Cite this article: EFORT Open Rev 2021;6:905-917. DOI: 10.1302/2058-5241.6.210064
Collapse
Affiliation(s)
- Olga Savvidou
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.,These authors contributed equally to this manuscript
| | - Olympia Papakonstantinou
- Second Department of Radiology, National and Kapodistrian University of Athens, Medical School, Attikon University General Hospital, Athens, Greece.,These authors contributed equally to this manuscript
| | - Eleftheria Lakiotaki
- First Department of Pathology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.,These authors contributed equally to this manuscript
| | - Ioannis Zafeiris
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | - Dimitra Melissaridou
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | - Pinelopi Korkolopoulou
- First Department of Pathology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.,Co-senior authors
| | - Panayiotis J Papagelopoulos
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.,Co-senior authors
| |
Collapse
|
4
|
Aguilera-Bohórquez B, Leiva M, Pacheco J, Calvache D, Fernandez M, Cantor E. Pain relief and good functional outcomes after hip endoscopy via posterior approach in patients with ischiofemoral impingement. Knee Surg Sports Traumatol Arthrosc 2021; 29:2394-2400. [PMID: 33025053 DOI: 10.1007/s00167-020-06309-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Ischiofemoral impingement is considered to be an uncommon and difficult pathology to diagnose with respect to hip pain etiology. The objective was to describe the clinical results of endoscopic lesser trochanter resection via a posterior approach in patients with Ischiofemoral impingement. METHODS This was a retrospective observational study of consecutive patients with Ischiofemoral impingement, who underwent endoscopic resection of the lesser trochanter via a posterior approach, between 2015 and 2018. Clinical results were evaluated using the ischiofemoral impingement test, long-stride walking test, modified Harris Hip Score (mHHS) and the Oxford scale to assess the strength of the iliopsoas muscle as well as the presence of complications. Preoperative and postoperative ischiofemoral space was measured to assess whether the resection of the lesser trochanter was adequate. RESULTS 16 hips in 13 patients (mean age: 34.4 ± 12.1 years, 11 women) with a follow-up period between 24 and 59 months were included. Preoperative ischiofemoral space ranged from 6.4 to 22.4 mm, a measure > 17.0 mm was achieved in 15 hips without the presence of pain in IFI test and long-strides walking test. Function improved postoperatively, as reflected by a higher mean mHHS (preoperative: 44.6 ± 21.5, postoperative: 81.2 ± 15.1, p < 0.05). After surgery, the strength of the iliopsoas muscle was not decreased compared to the preoperative measure. Three complications were reported, including two cases that required revision surgery. CONCLUSIONS Endoscopic resection of the lesser trochanter via posterior approach provides satisfactory outcomes with symptom relief and good functional results in patients with Ischiofemoral impingement. It is important to discuss the benefits and risks when offering this treatment choice. LEVEL OF EVIDENCE Level IV.
Collapse
Affiliation(s)
- Bernardo Aguilera-Bohórquez
- Hip Preservation Unit, Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Carrera 38A, No. 5a-100, Tower A-Office 105, Cali, Colombia.
| | - Mario Leiva
- Hip Preservation Unit, Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Carrera 38A, No. 5a-100, Tower A-Office 105, Cali, Colombia.,Fellow of Preservation Surgery and Hip Endoscopy, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Julio Pacheco
- Hip Preservation Unit, Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Carrera 38A, No. 5a-100, Tower A-Office 105, Cali, Colombia.,Fellow of Preservation Surgery and Hip Endoscopy, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Daniela Calvache
- Hip Preservation Unit, Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Carrera 38A, No. 5a-100, Tower A-Office 105, Cali, Colombia
| | - Miguel Fernandez
- Hip Preservation Unit, Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Carrera 38A, No. 5a-100, Tower A-Office 105, Cali, Colombia.,Fellow of Preservation Surgery and Hip Endoscopy, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Erika Cantor
- Institute of Statistics, Universidad de Valparaiso, Valparaiso, Chile
| |
Collapse
|
5
|
Güney B, Doğan E, Özdemir MY. Osteochondroma as a Cause of Ischiofemoral Impingement - First Case Series. Acta Med Litu 2021; 28:189-194. [PMID: 34393644 PMCID: PMC8311847 DOI: 10.15388/amed.2021.28.1.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/22/2022] Open
Abstract
Ischiofemoral impingement (ISFI)is the compression of the quadratus femoris muscle resulting from the narrowed distance between the lesser trochanter and the ischial bone. Congenital factors (such as developmental hip dysplasia), positional conditions (such as femoral anteversion), intertrochanteric fractures, osteotomy, and osteoarthritis may lead to the superior and medial displacement of the femur which is causing the ISFI. According to the literature, osteochondroma (OC) is not described among the main etiological factors of ISFI. There is only one case report about the relationship between ISFI and OC. We present two ISFI cases due to OC accompanied by radiological findings. Our patients are 19 and 32 years old. Our article is the first case series on this topic.
Collapse
Affiliation(s)
- Bünyamin Güney
- Muğla Sıtkı Koçman University, Faculty of Medicine, Radiology, Turkey
| | - Emrah Doğan
- Muğla Sıtkı Koçman University, Faculty of Medicine, Radiology, Turkey
| | | |
Collapse
|