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With extra-articular impingement, structures outside the hip joint itself collide, for example bone against bone or tendon against implant. This causes pain in specific positions.
What is extra-articular impingement?
The classic form of impingement occurs inside the joint (femoroacetabular impingement). With extra-articular impingement, the conflict lies outside the joint.
Common forms:
- Ischiofemoral impingement: the femur comes too close to the ischium (more info)
- Subspine impingement: conflict with a prominent bony ridge above the socket
- Trochantero-pelvic impingement: the greater trochanter touches the pelvis in extreme positions
- Conflict with new bone formed after a hip replacement (heterotopic ossification)
Possible symptoms
- Pain in a specific position, for example when extending or widely abducting the leg
- Deep pain in the buttock with long strides or on stairs
- A blocking or clashing sensation when rotating
- Limited range of motion not explained by the joint itself
Treatment
Imaging with CT or MRI shows exactly where the conflict occurs.
- Load adjustment and targeted physiotherapy to improve movement control
- A targeted, ultrasound-guided injection can be both diagnostic and therapeutic
- Removal of the impinging bone, arthroscopically or through a small open procedure
- With impingement after a replacement, sometimes an adjustment of the components
Not sure where your complaints come from? Use the symptom explorer or book an appointment with one of our hip surgeons.
Frequently asked questions
Other hip conditions
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