The quadratus femoris is the most inferior of the short external rotators (the "POGO" muscles — piriformis, obturator internus/externus, gemelli, quadratus femoris). It is the reference muscle for the ischiofemoral space.
| Origin | Lateral border of the ischial tuberosity — inferior aspect |
|---|---|
| Insertion | Intertrochanteric crest of the femur — quadrate tubercle |
| Nerve Supply | Nerve to quadratus femoris (L4, L5, S1) |
| Blood Supply | Inferior gluteal and circumflex femoral arteries |
| Actions | Externally rotates the hip — a strong lateral rotator; Adducts the hip |
|---|
Ischiofemoral impingement occurs when the quadratus femoris is compressed between the ischial tuberosity and the lesser trochanter. MRI shows oedema within the quadratus femoris as the hallmark. Ischiofemoral impingement produces posterior hip and buttock pain reproduced by walking (especially with a long stride) and is managed by activity modification, injection, or surgical decompression.
Not directly palpable. Assessed by the ischiofemoral impingement test (long stride walking pain).
Quadratus femoris compression between the ischium and lesser trochanter producing posterior hip pain with ambulation, identified by MRI oedema pattern and managed by injection or surgical ischiofemoral space widening.
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