Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions

Krueger, David R.; Windler, Markus; Geßlein, Markus; Schuetz, Michael; Perka, Carsten; Schroeder, J.

doi:10.1007/s00402-017-2694-y

Cited by 10 publications

(10 citation statements)

References 18 publications

(23 reference statements)

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“…Figure 1 shows a flowchart illustrating study screening and eligibility assessment. This process identified 23 studies, of which 6 were imaging diagnosis studies, 2 , 4 , 6 , 18 , 22 , 35 9 were prevalence studies, 2 , 5 , 21 , 23 – 25 , 27 , 32 , 33 9 reported outcomes after arthroscopic treatment, ∥ and 9 studies ¶ reported on adverse effects after arthroscopic treatment.…”

Section: Resultsmentioning

confidence: 99%

“…A summary of the 6 studies 2 , 4 , 6 , 18 , 22 , 35 on diagnostic imaging accuracy is shown in Table 1 . Plain radiographs, 3-dimensional reconstructed CT (3D-CT), MRI, and US were used for diagnosis of AIIS impingement.…”

Section: Resultsmentioning

confidence: 99%

“…This process identified 23 studies, of which 6 were imaging diagnosis studies, 2,4,6,18,22,35 prevalence studies, 2,5,21,23-25,27,32,33 9 reported outcomes after arthroscopic treatment, k and 9 studies { reported on adverse effects after arthroscopic treatment. A summary of the 6 studies 2,4,6,18,22,35 on diagnostic imaging accuracy is shown in Table 1. Plain radiographs, 3-dimensional reconstructed CT (3D-CT), MRI, and US were used for diagnosis of AIIS impingement.…”

Section: Resultsmentioning

confidence: 99%

“…Plain radiographic imaging is a basic tool for identifying AIIS. 22 Although morphological classification of AIIS based on CT images is established, 16 actual impingement between the AIIS and the femur during motion cannot be visualized on a static image. Therefore, Hetsroni et al 16 conducted computer simulation analyses to show that range of motion (ROM) was limited significantly in cases with prominent AIIS morphology (type 2 or 3).…”

Section: Discussionmentioning

confidence: 99%

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Imaging Diagnosis, Prevalence, and Clinical Outcomes of Arthroscopic Surgery for Anterior Inferior Iliac Spine Impingement: A Systematic Review and Meta-analysis

Kobayashi

Kamono

Yamamoto

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Subspine impingement, or anterior inferior iliac spine (AIIS) impingement, is a type of extra-articular pathology associated with femoroacetabular impingement syndrome and often requires subsequent arthroscopic surgery. Purpose: To examine the diagnostic accuracy, prevalence, and clinical outcomes of arthroscopic treatment for AIIS impingement. Study Design: Systematic review; Level of evidence, 4. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist was applied. We searched for studies on the prevalence, diagnostic accuracy, and results of surgical treatment for AIIS impingement. For each included study, data synthesis and statistical analysis were performed to identify pooled prevalence, calculate clinical outcome scores, and estimate adverse events. The QUADAS (a quality assessment tool for diagnostic accuracy studies) was used to assess the quality of the diagnostic accuracy studies, and the Risk of Bias Assessment tool for Nonrandomized Studies was used to assess the quality of the studies on arthroscopic treatment efficacy. Results: Out of an initial 791 studies, 23 were included. AIIS impingement was diagnosed by plain radiography with 76% to 86% sensitivity, 3-dimensional computed tomography with 80% to 81.8% sensitivity, magnetic resonance imaging with 80% sensitivity, and ultrasound with 92.5% sensitivity. For patients who underwent hip arthroscopy, the pooled prevalence of AIIS impingement was 18%. Significant improvement between pre- and postoperative clinical outcomes was observed: 25.75 points for the modified Harris hip score (mHHS), 46.88 points for the Hip Outcome Score–Sport subscale, 20.85 points for the Nonarthritic Hip Score, and -2.92 points for the pain visual analog scale. The minimal clinically important difference on the mHHS was exceeded by 94% of patients. The pooled incidence of surgical complications was 1%. Of 6 included studies on diagnostic accuracy, 2 were identified as having a low risk of bias, and 4 included >2 factors with a high risk of bias. All 9 included studies on treatment outcomes had at least 1 factor with a high risk of bias. Conclusion: Several imaging modalities assist in the diagnosis of AIIS impingement. The overall prevalence of AIIS impingement in patients that underwent hip arthroscopy was 18%. Clinical outcomes after arthroscopic AIIS decompression were generally favorable, with a relatively low rate of surgical complications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Imaging Diagnosis, Prevalence, and Clinical Outcomes of Arthroscopic Surgery for Anterior Inferior Iliac Spine Impingement: A Systematic Review and Meta-analysis

Kobayashi

Kamono

Yamamoto

et al. 2022

Orthopaedic Journal of Sports Medicine

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“…A study by Krueger et al 23 investigated the role of the conventional AP pelvis X-ray in evaluating the projection of the AIIS. They concluded that a precise distinction of the AIIS morphology was not possible in the AP view, and in their cases a distal extension of the AIIS below the anterior acetabular rim was related to type II and III AIIS morphologies in the CT reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic management of anterior inferior iliac spine impingement: a systematic review

Fioruzzi

Jannelli

Iovone

et al. 2019

Muscle Ligaments and Tendons J

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Introduction: Subspine impingement is characterized by a prominent anterior inferior iliac spine that creates an abnormal contact with the distal femoral neck during hip movements. Currently, the clinical picture and diagnostic criteria are still being refined for these conditions. This study aimed to systematically review the literature on the subspine impingement arthroscopic treatment to elucidate the indication for and clinical outcome of surgical arthroscopic decompression of the anterior inferior iliac spine. Methods: The PubMed and Web of Science library were searched for any publications using the terms "subspine impingement" and "subspine impingement hip" in the "Title, Abstract, Keywords" field. The search was extended to all the literature on the topic. Results: Overall, 127 studies were initially retrieved; ultimately, 8 studies were included examining 361 hips. The arthroscopic decompression of the anterior inferior iliac spine resulted in a mean 18.5 degrees improvement in flexion, as well as im-provements in pain and functional outcome scores. Conclusion: This review suggests that arthroscopic decompression of a symptomatic anterior inferior iliac spine deformity can provide excellent outcomes at short-term follow-up in the absence of significant complications and recurrences. Level of evidence: IIIa.

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Subspine Impingement

Rath,

Czinn

2024

Orthopaedic Sports Medicine

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Is the evaluation of the anterior inferior iliac spine (AIIS) in the AP pelvis possible? Analysis of conventional X-rays and 3D-CT reconstructions

Abstract: Distinct differentiation of the AIIS morphology in the AP pelvis is not possible, but the projection of the AIIS below the anterior acetabular rim represented a hypertrophic AIIS in all cases and should, therefore, be critically investigated for a relevant AIIS impingement.

Cited by 10 publications

References 18 publications

Imaging Diagnosis, Prevalence, and Clinical Outcomes of Arthroscopic Surgery for Anterior Inferior Iliac Spine Impingement: A Systematic Review and Meta-analysis

Imaging Diagnosis, Prevalence, and Clinical Outcomes of Arthroscopic Surgery for Anterior Inferior Iliac Spine Impingement: A Systematic Review and Meta-analysis

Arthroscopic management of anterior inferior iliac spine impingement: a systematic review

Subspine Impingement

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