J Rheum Dis.  2016 Jun;23(3):179-182. 10.4078/jrd.2016.23.3.179.

A Case of Ischiofemoral Impingement Syndrome as a Differential Diagnosis of Ankylosing Spondylitis

Affiliations
  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 2Division of Rheumatology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. lhsberon@hanyang.ac.kr
  • 3Department of Radiology, Hanyang University Guri Hospital, Guri, Korea.

Abstract

Ischiofemoral impingement (IFI) syndrome is an uncommon cause of gluteal and hip pain. We report on a case of a 20-year-old man who presented with chronic gluteal and hip pain with low back pain without a history of trauma or surgery. He was misdiagnosed with ankylosing spondylitis (AS) at another clinic. The patient was finally diagnosed with IFI syndrome according to pelvic magnetic resonance imaging findings at our hospital. After two weeks of medical and physical treatment, his pain showed gradual improvement. Because IFI syndrome is rarely reported in male patients, it might be misdiagnosed as AS. Therefore, IFI syndrome should be considered as a differential diagnosis of AS, particularly in young male patients with atypical pain characteristics.

Keyword

Ischiofemoral impingement syndrome; Ankylosing spondylitis

MeSH Terms

Diagnosis, Differential*
Hip
Humans
Low Back Pain
Magnetic Resonance Imaging
Male
Spondylitis, Ankylosing*
Young Adult

Figure

  • Figure 1. Plain radiograph of the pelvis, showing suspicious mild sclerotic lesions of the right sacroiliac joint (arrow).

  • Figure 2. (A) T1-weighted magnetic resonance imaging (MRI), showing no definite findings of sacroiliitis. (B) T2-weighted fat-suppressed MRI, revealing bilateral narrowing of the ischiofemoral space (arrows) with increased signal intensity of the quadratus femoris muscles (arrowheads).


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