Bilateral Ischiofemoral Impingement on Hip MRI: A Case-Based Guide to Deep Buttock Pain, Quadratus Femoris Edema, and Clinical Management
A MediAI Clinical Imaging Column | ScholarGen Introduction: When Buttock Pain Has an Unexpected Cause Persistent buttock pain can be difficult to diagnose because several musculoskeletal and neurologic conditions produce similar symptoms. Lumbar radiculopathy, hip osteoarthritis, sacroiliac joint dysfunction, proximal hamstring tendinopathy, and deep gluteal syndrome may all present with pain around the posterior hip or buttock. One less frequently recognized cause is ischiofemoral impingement (IFI) , an extra-articular hip disorder associated with narrowing of the space between the ischium and the lesser trochanter of the femur. This narrowing may compress the quadratus femoris muscle, producing edema, abnormal MRI signal, and, in chronic cases, muscle atrophy or fatty replacement. Unlike femoroacetabular impingement, which involves abnormal contact between the proximal femur and acetabular structures, ischiofemoral impingement occurs outside the hip joint. Consequently, an imag...