Ischiofemoral impingement syndrome is a neglected cause of posterior hip pain which is derived from narrowing of the space between the lateral aspect of the ischium and the medial aspect of the lesser trochanter. Its diagnosis is challenging and requires the combination of physical tests and imaging studies. In the present narrative review, we found that femoral anteversion predisposes patients to the narrowing of the ischiofemoral space and subsequent quadratus femoris muscle injury. Magnetic resonance imaging serves as the gold-standard diagnostic tool, which facilities the quantification of the ischiofemoral distance and the recognition of edema/fat infiltration/tearing of the quadratus femoris muscle. Ultrasound is useful for scrutinizing the integrity of deep gluteal muscles, and its capability to measure the ischiofemoral space is comparable to that of magnetic resonance. Various injection regimens can be applied to treat ischiofemoral impingement syndrome under ultrasound guidance and they appear to be safe and effective. Finally, more randomized controlled trials are needed to build solid bases of evidence on ultrasound-guided interventions in the management of ischiofemoral impingement syndrome.

1st Faculty of Medicine Institute of Anatomy Charles University 12800 Prague Czech Republic

Center for Regional Anesthesia and Pain Medicine Wang Fang Hospital Taipei Medical University Taipei 11600 Taiwan

Department of Medical Imaging National Cheng Kung University Hospital College of Medicine National Cheng Kung University No 1 University Rd Tainan 70101 Taiwan

Department of Physical and Rehabilitation Medicine Hacettepe University Medical School Ankara 06100 Turkey

Department of Physical Medicine and Rehabilitation College of Medicine National Taiwan University Taipei 10048 Taiwan

Department of Physical Medicine and Rehabilitation National Taiwan University Hospital Bei Hu Branch Taipei 10845 Taiwan

Department of Physical Medicine and Rehabilitation Taichung Veterans General Hospital Taichung 40705 Taiwan

Department of Rehabilitation Medicine 1st Faculty of Medicine and General University Hospital Prague Charles University 12800 Prague Czech Republic

Physical and Rehabilitation Medicine Unit Luigi Sacco University Hospital ASST Fatebenefratelli Sacco 20157 Milan Italy

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