LIGAMENTUM TERES

Arises from and around the transverse ligament and inserts onto fovea Surrounded by synovial sheath Function uncertain, does have a vascular role and probably assists with hip stability Can tear, either complete or partial and develop ganglia

Hyperabduction and flexion may lead toinjury Can be torn, degenerate and develop cysts

ISCHIOFEMORAL IMPINGEMENT

Narrowing of the space between the ischium and lesser trochanter may lead to symptoms. In some cases, patients complain of pain. In others there is at palpable or audible click or grating on walking.

Probably ore common in women Some plain xray findings are noted, ischial enlargement and sclerosis But xray rotation can create spurious findings

The imaging hallmark is narrowing of the space on axial MRI.

13mm has been suggested as a measurement, but the range is wide (5mm)

Occasionally increased signal is identified within the quadrants femoris muscle.

In long-standing cases, muscle atrophy may be present.

Not all patients with narrowing of the IF space are symptomatic US or CTguided local anaesthetic block may help distinguish IFI from other causes of pain Surgical options include resection of lesser trochanter and ischium

PECTINEOFOVEAL IMPINGEMENT

Possible syndrome but not confirmed Related to the medial synovial fold in the inferior joint No convincing MRI findings as some supposed positive findings are also found in asymptomatic individuals

SUBSPINE IMPINGEMENT

Extra-articular cause of impingement Impingement of direct RF head against the femoral neck Look for an enlarged AIIS - various types described Grinding senstion on flexion and lateral translation

Possible prior history of RF avulsion • acetabular retroversion • elongation/hooking of AIIS • AIIS below the anterior sourcil

• Cysts on anterior femoral neck

EXTERNAL SNAPPING HIP

See separate section - link on the side menu