Ischiofemoral impingement syndrome: another cause of extraspinal sciatica

Abstract

A 76-year-old woman was admitted to our hospital with complaints of right buttock pain and sciatica. Magnetic resonance imaging was performed. The magnetic resonance imaging showed right ischiofemoral narrowing, edema, and increased signal intensity within the quadratus femoris muscle (Fig. 1). The initial visual analogue scale was 8–9. Computerized tomography-guided percutaneous steroid and local anesthetic injection was performed. Then non-steroidal antiinflammatory drug treatment and exercise program was initiated. After 12 weeks of treatment, pain of the right hip was decreased gradually to visual analogue scale 2–3. Ischiofemoral space is the smallest distance between the ischial tuberosity and lesser trochanter of the femuron axial T1weighted images. Ischiofemoral impingement is characterized by abnormalities of quadratus femoris muscle and narrowing of the space between the lesser trochanter of the femur and the ischial bone (1). It is usually seen in women and is a rare cause of sciatica. The common causes are history of surgery, fracture or arthrosis, hamstrings tendinopathy, or congenital.