Unusual ischiofemoral impingement secondary to osteochondroma in an elderly patient with thoracolumbar kyphosis: A case report

• Published in: Journal of Orthopaedic Reports Vol. 2; no. 4; p. 100223
• Main Authors: Corpus-Zuñiga, Fidelis Marie, Muramatsu, Keiichi, Yamashita, Yosuke, Tec, Lou Mervyn
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2023; Elsevier
• Subjects: Femur; Ischiofemoral impingement; Osteochondroma; Resection; Vertebral kyphosis; Osteochondroma; Femur; Resection; Vertebral kyphosis; Ischiofemoral impingement
• ISSN: 2773-157X; 2773-157X
• DOI: 10.1016/j.jorep.2023.100223

Common causes of hip pain the elderly are usually due to osteoarthritic changes in the joint, fracture or referred pain from thoracolumbar spine degenerative disease. One of the less common causes of hip pain is ischiofemoral impingement. Even less common is finding an osteochondroma of the proximal femur in the elderly that could cause ischiofemoral impingement. We present a case of ischiofemoral impingement secondary to osteochondroma of the proximal femur in a 78-year-old female after a thoracic vertebral fracture. A patient had severe posterior hip pain after compression fracture of the 11th thoracic vertebra. Radiographs showed a bone tumor at the lesser trochanter of the femur. Needle biopsy was done with a histopathology of osteochondroma. We diagnosed as ischiofemoral impingement secondary to osteochondroma and a marginal resection of the tumor was done. The patient had complete pain relief soon after surgery. The vertebral fracture caused thoracic hyperkyphosis, which made the patient compensate for balance by pelvic retroversion and hip extension. This compensation in pelvic and hip alignment further narrowed and closed the ischiofemoral space, hence causing her symptoms.